Edgewood Missoula Senior Living LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

11326 Issued in MT

Legal business name

EDGEWOOD MISSOULA SENIOR LIVING LLC

Practice address

2815 Palmer St
Missoula, MT 59808-1643

Phone

(406) 549-9660

Fax

(406) 549-4424

NPI assigned

Jan 18, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gene Hysjulien

Title

Ceo

Phone

(701) 738-2000

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1700062957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 24TH AVE S",
            "address_2": "SUITE 201",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015831",
            "telephone_number": "701-738-2000",
            "fax_number": "701-738-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 PALMER ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081643",
            "telephone_number": "406-549-9660",
            "fax_number": "406-549-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD MISSOULA SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "HYSJULIEN",
        "authorized_official_first_name": "GENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-738-2000"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "MT",
            "license": "11326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eating Disorder Center of Montana
• Lillian Eaton
• Timothy James Eberwein, LMT
• Hailee Marie Eckman, ATC
• Margaret A Eddy, MD
• Edgewood Vista
• Educational Services, Inc. (Aerie Backcountry Medicine)
• Bridget Edwards, L.C.P.C.
• Richard Allen Edwards, LAC
• Heidi Efinger, NP-C

• Alzheimer Center (Dementia Center) in Missoula, MT
• Providers in Missoula, MT by specialty
• Alzheimer Center (Dementia Center) in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.