Organization
EDGEWOOD GRAND FORKS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DYBWAD (VP FINANCE/BUDGET)
(701) 757-5422
Entity
Organization
Contact information
Practice address
1800 47TH AVE S, GRAND FORKS, ND 58201
(701) 738-2000
(701) 738-2001
Mailing address
PO BOX 13238, GRAND FORKS, ND 58208-3238
(701) 738-2000
(701) 738-2001
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Enumeration date
02/24/2022
Last updated
09/04/2024
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