National Provider Identifier Database

EDGEWOOD VISTA SENIOR LIVING INC
Assisted Living Facility

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.


Contact Information

EDGEWOOD VISTA SENIOR LIVING INC
540 FALCON CREST DR
SPEARFISH, SD57783-3255
Phone: 605-642-2977
Fax:
Website:
Specialty Taxonomy Code
* Assisted Living Facility 310400000X
Alzheimer Center /Dementia Center/Dementia Special Care Unit 311500000X

* Indicates primary specialty

NPI Profile & details for EDGEWOOD VISTA SENIOR LIVING INC

NPI Number 1548313992
Legal business name
LBN
EDGEWOOD VISTA SENIOR LIVING INC
Authorized official ANN WAGNER - (ACCOUNTS RECEIVABLE CLERK)
Entity Organization
Organization subpart No
Enumeration date 01/19/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • SD License #: 11073
  • SD License #: 49736
  • SD Medicaid: 9570693

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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