Organization
EDGEWOOD SPEARFISH SENIOR LIVING LLC
Active
Organization
EDGEWOOD SPEARFISH 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
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
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
49736
SD
Other
Enumeration date
01/14/2008
Last updated
01/14/2008
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