Organization Name: | EDGEWOOD SPEARFISH SENIOR LIVING LLC |
NPI Number: | 1922284033 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GENE HYSJULIEN HYSJULIEN (CEO) |
Mailing Address: | 540 Falcon Crest Dr Spearfish |
State: | SD US |
Postal Code: | 577833255 |
Phone Number: | 7017382000 |
Fax Number: | 7017382001 |
NPI Enumeration Date: | 01/18/2008 |
NPI Last Update Date: | 01/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | 49736 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
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. |