Organization
EDGEWOOD VISTA SENIOR LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN M WAGNER (ACCOUNTS RECEIVABLE CLERK)
(701) 738-2000
Entity
Organization
Contact information
Practice address
3406 DOMINION ST, BISMARCK, ND 58503-5577
(701) 258-7489
Mailing address
PO BOX 13336, 2450 24TH AVE S SUITE 201, GRAND FORKS, ND 58208-3336
(701) 738-2000
(701) 738-2001
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
1
ND
310400000X
Assisted Living Facility
15
ND
311500000X
Alzheimer Center (Dementia Center)
Primary
8057A
ND
311500000X
Alzheimer Center (Dementia Center)
8058A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30721
—
ND
05
—
30751
—
ND
05
—
32083
—
ND
05
—
39962
—
ND
Enumeration date
01/19/2007
Last updated
09/11/2025
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