Organization
EDGEWOOD FARGO SENIOR LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENE HYSJULIEN (CEO)
(701) 738-2000
Entity
Organization
Contact information
Practice address
4420 37TH AVE S, FARGO, ND 58104-3400
(701) 365-8200
(701) 365-8200
Mailing address
2850 24TH AVE S, SUITE 201, GRAND FORKS, ND 58201-5831
(701) 738-2000
(701) 738-2001
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
8103A
ND
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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