Edgewood Vista Senior Living Inc
LBN: Edgewood Vista Senior Living Inc
Edgewood Vista Senior Living Inc is an health care organization with primary practice located at 540 Falcon Crest Dr , Spearfish SD 57783-3255. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center). Nursing & Custodial Care Facilities / Assisted Living Facility is the primary health care specialty.
Edgewood Vista Senior Living Inc can be contacted via phone (605) 642-2977, or through Wagner, Ann M via phone (701) 738-2000.
Contact Information
Primary practice address
540 Falcon Crest Dr
Spearfish SD 57783-3255
Phone: (605) 642-2977
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Assisted Living Facility | 310400000X | 49736 | South Dakota |
| Nursing & Custodial Care Facilities / Assisted Living Facility | 310400000X | 11073 | South Dakota |
| Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center) | 311500000X | 49736 | South Dakota |
| Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center) | 311500000X | 11073 | South Dakota |
Profile Details
| NPI number | 1548313992 |
|---|---|
| LBN Legal business name | Edgewood Vista Senior Living Inc |
| DBA Doing business as | |
| Authorized official | Wagner, Ann M |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Aug 22nd, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548313992 | NPPES |
| South Dakota | MEDICAID | 9570693 |
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