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Organization

EDGEWOOD SPEARFISH SENIOR LIVING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GENE HYSJULIEN HYSJULIEN (CEO)
(701) 738-2000
Entity
Organization

Contact information

Practice address
540 FALCON CREST DR, SPEARFISH, SD 57783-3255
(701) 738-2000
(701) 738-2001
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
49736
SD

Other

Enumeration date
01/18/2008
Last updated
01/18/2008
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