Organization
EDGEWOOD RAPID CITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DYBWAD (VICE PRESIDENT OF FINANCE)
(701) 757-5422
Entity
Organization
Contact information
Practice address
4001 DERBY LANE, RAPID CITY, SD 57701
(605) 718-3600
(701) 738-2001
Mailing address
322 DEMERS AVE STE 500, GRAND FORKS, ND 58201
(701) 757-5410
(701) 738-2001
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/10/2019
Last updated
01/14/2019
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