Organization
EDGEWOOD PIERRE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REX CARLSON (TREASURER)
(701) 757-5463
Entity
Organization
Contact information
Practice address
1950 E 4TH ST, PIERRE, SD 57501-4201
(605) 494-3400
Mailing address
322 DEMERS AVE STE 500, GRAND FORKS, ND 58201-4799
(701) 757-5410
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
66437
SD
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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