Edgewood Alexandria Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EDGEWOOD ALEXANDRIA SENIOR LIVING LLC

Doing business as

Clearwater Suites

Practice address

1902 7TH Ave E
Alexandria, MN 56308-2364

Phone

(320) 759-2121

NPI assigned

Oct 20, 2009

Last updated

Oct 20, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Philip Gisi

Title

President/Treasurer

Phone

(701) 757-4700

Specialties & licenses 1

Addresses

Other names 1

• Clearwater Suites Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1780910117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 24TH AVE S",
            "address_2": "SUITE 200",
            "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": "1902 7TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082364",
            "telephone_number": "320-759-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD ALEXANDRIA SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "GISI",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT/TREASURER",
        "authorized_official_telephone_number": "701-757-4700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clearwater Suites",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Ann Earley
• Hailey Rose Ebacher
• Ecumen (Bethany Home of Alexandria)
• Ecumen (Ecumen Home Care - Bethany)
• Ecumen Properties Inc. (Bethany Home Health Services)
• Thomas R Edwards, MD
• Ann Celeste Ehlert, PHARMD
• Jeremy James Ehlert, RPH, PHARM.D.
• Aspen Kay Ehrenberg
• Einerson Family Dentistry PLLC

• Assisted Living Facility in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.