Organization
EDGEWOOD MANDAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RON WHETTER (VP FINANCE/BUDGET)
(218) 230-5953
Entity
Organization
Contact information
Practice address
2801 39TH AVE SE, MANDAN, ND 58554-6430
(701) 663-5664
Mailing address
322 DEMERS AVE, SUITE 500, GRAND FORKS, ND 58201-4754
(218) 230-5953
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
88
ND
310400000X
Assisted Living Facility
Primary
AL68
ND
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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