Organization
EDGEBROOK ESTATES ASSISTED LIVING
Active
Parent organization
EDGEBROOK CARE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDGEBROOK CARE CENTER
Authorized official
MR. PHILIP SAMUELSON (ADMINISTRATOR)
(507) 442-7121
Entity
Organization
Contact information
Practice address
301 5TH AVE N, EDGERTON, MN 56128-1298
(507) 442-5080
(507) 442-5101
Mailing address
505 TROSKY RD W, EDGERTON, MN 56128-2748
(507) 442-7121
(507) 442-3952
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
344300
MN
310400000X
Assisted Living Facility
Primary
344559
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7122419
—
MN
Enumeration date
05/10/2010
Last updated
05/10/2010
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