Organization
EDGEWOOD VISTA SENIOR LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENE HYSJULIEN (CEO)
(701) 738-2000
Entity
Organization
Contact information
Practice address
715 17TH AVE SE, MINOT, ND 58701-6753
(701) 838-5569
(701) 838-0613
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
8057A
ND
Other
Enumeration date
03/24/2008
Last updated
03/24/2008
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