NPI 1205010147

Edgewood Brainerd Senior Living LLC

Organisation Assisted Living Facility Brainerd, MN

Practice location

Address: 14890 Beaver Dam Rd, Brainerd, MN 56401-6019
Phone: (701) 738-2000
Fax: (701) 738-2001
Mailing address: 2850 24th Ave S Suite 201, Grand Forks, ND 58201-5831

Authorised official

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

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 338402 (MN)

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Registry record

NPI: 1205010147
Entity type: Organization
NPI issued: 27 Dec 2007
Record last updated: 27 Dec 2007

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.