# EDGEWOOD GRAND FORKS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598475766
- **Authorized official:** MR. JOHN DYBWAD (VP FINANCE/BUDGET)
- **Authorized official phone:** (701) 738-2000

## Contact information

- **Practice address:** 1800 47TH AVE S, GRAND FORKS, ND 58201-2836
- **Practice address phone:** (701) 738-2000
- **Mailing address:** PO BOX 13238, GRAND FORKS, ND 58208-3238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | — | NULL | Yes |

## Other

- **Enumeration date:** 11/29/2022
- **Last updated:** 11/29/2022