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Organization
BLAINE CARE GROUP LLC
Active
Organization
BLAINE CARE GROUP LLC
Active
Other names
Edgemont Place Alzheimer's Special Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W. CODY ERWIN (MANAGING MEMBER)
(360) 772-1645
Entity
Organization
Contact information
Practice address
11748 ULYSSES LANE NE, BLAINE, MN 55434
(763) 862-7000
(763) 862-7001
Mailing address
5101 NE 82ND AVE STE 200, VANCOUVER, WA 98662-6343
(360) 254-9442
(360) 254-1770
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
06/03/2021
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