Edgewood Spearfish Senior Living LLC

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

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 14, 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

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.

• Edgewood Spearfish Senior Living LLC

  • Assisted Living Facility
  • Spearfish, SD
  • NPI 1922284033
  NPD tax ID

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1942486584",
    "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": "2008-01-14",
        "last_updated": "2008-01-14",
        "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": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "SD",
            "license": "49736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Rae Dorsett, LN
• Vickie Dowdy, LMT
• Garry K Dunn, M.D.
• Michael Edward Easley, LPC
• Edgewood Spearfish Senior Living LLC
• Edgewood Vista Senior Living Inc
• Heath Eggleston
• Eklund Chiropractic PC
• Lee Earll Eklund
• Elevate Senior Healthcare

• Assisted Living Facility (Behavioral Disturbances) in Spearfish, SD
• Providers in Spearfish, SD by specialty
• Assisted Living Facility (Behavioral Disturbances) in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.