NPIMap

Organization Active NPI

Edgewood Spearfish Senior Living LLC

  • Assisted Living Facility
  • Spearfish, SD
National Provider Identifier
1922284033
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
49736 Issued in SD
Legal business name
EDGEWOOD SPEARFISH SENIOR LIVING LLC
Practice address
540 Falcon Crest Dr
Spearfish, SD 57783-3255
Phone
(701) 738-2000
Fax
(701) 738-2001
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Authorized official

Name
Gene Hysjulien Hysjulien
Title
Ceo
Phone
(701) 738-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 49736 SD Primary

Addresses

Primary practice location

540 Falcon Crest Dr
Spearfish, SD 57783-3255

Mailing address

2850 24TH Ave S
Suite 201
Grand Forks, ND 58201-5831
Phone (701) 738-2000

National Provider Directory

National Provider Directory
Tax ID family
Edgewood Spearfish Senior Living LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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": "1922284033",
    "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": "540 FALCON CREST DR",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577833255",
            "telephone_number": "701-738-2000",
            "fax_number": "701-738-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD SPEARFISH 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 HYSJULIEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-738-2000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "49736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spearfish, SD

Sources for this page

  • 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.