Organization
EDGEWOOD PLANTATION PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DYBWAD (VP OF FINANCE)
(701) 757-5422
Entity
Organization
Contact information
Practice address
3921 KESSINGER LN, BOISE, ID 83703-3003
(208) 853-7300
(208) 853-9328
Mailing address
PO BOX 13238, GRAND FORKS, ND 58208
(701) 738-2000
(208) 853-9328
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
83703
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0000774
—
ID
Enumeration date
07/06/2011
Last updated
08/18/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up