Organization Name: | EDGEBROOK ESTATES ASSISTED LIVING |
NPI Number: | 1548588957 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PHILIP SAMUELSON (ADMINISTRATOR) |
Mailing Address: | 301 5th Ave N Edgerton |
State: | MN US |
Postal Code: | 561281298 |
Phone Number: | 5074425080 |
Fax Number: | 5074425101 |
NPI Enumeration Date: | 05/10/2010 |
NPI Last Update Date: | 05/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | 344300 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |