NPI 1083089825

Edgewood Prairie Crossings Watertown Il LLC

Organisation Assisted Living Facility Watertown, SD

Practice location

Address: 901 14th Ave NE, Watertown, SD 57201-6817
Phone: (605) 882-3084
Mailing address: 322 Demers Ave STE 500, Grand Forks, ND 58201-4799

Authorised official

Name: Rex Carlson
Title: Treasurer
Phone: (701) 757-5463

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1083089825
Entity type: Organization
NPI issued: 4 Dec 2015
Record last updated: 4 Dec 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.