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Organization
EDGEWOOD BAXTER LLC
Active
Organization
EDGEWOOD BAXTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REX CARLSON (CFO)
(701) 757-5465
Entity
Organization
Contact information
Practice address
14211 FIREWOOD DR, BAXTER, MN 56425-8567
(701) 757-5465
Mailing address
PO BOX 13238, GRAND FORKS, ND 58208-3238
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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