# EDGEWOOD BISMARCK SENIOR LIVING, LLC

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

## Provider details

- **NPI number:** 1659543288
- **Authorized official:** JOHN DYBWAD (VP FINANCE/BUDGET)
- **Authorized official phone:** (701) 738-2000

## Contact information

- **Practice address:** 3406 DOMINION ST, BISMARCK, ND 58503-5577
- **Practice address phone:** (701) 258-7489
- **Practice address fax:** (701) 258-7491
- **Mailing address:** PO BOX 13238, GRAND FORKS, ND 58208-3238
- **Mailing address phone:** (701) 738-2000
- **Mailing address fax:** (701) 738-2001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | 8058A | ND | Yes |

## Other

- **Enumeration date:** 03/24/2008
- **Last updated:** 02/10/2025