Edgewood Hermantown I Senior Living Llc

LBN: Edgewood Hermantown I Senior Living Llc
Edgewood Hermantown I Senior Living Llc is an health care organization with primary practice located at 4195 Westberg Rd , Hermantown MN 55811-3916. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Edgewood Hermantown I Senior Living Llc can be contacted via phone (701) 738-2000, or through Whetter, Ron via phone (701) 738-2000.

Contact Information

Primary practice address
4195 Westberg Rd Hermantown MN 55811-3916
Phone: (701) 738-2000
Fax: (701) 738-2001
Website:
Map and Directions
Authorized official contact:
Name: Whetter, Ron
Phone: (701) 738-2000

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 338403 Minnesota

Profile Details

NPI number 1609050442
LBN Legal business name Edgewood Hermantown I Senior Living Llc
DBA Doing business as
Authorized official Whetter, Ron
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2007
Last updated May 26th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609050442 NPPES
Minnesota MEDICAID 338387
Minnesota MEDICAID 338369
Minnesota MEDICAID 338403

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