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) 365-8202
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
310400000X
Assisted Living Facility
Primary
70
ND
Other
Enumeration date
03/20/2008
Last updated
03/20/2008
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