EDGEWOOD VISTA SENIOR LIVING INC; NPI #1548313992

Contact Information

EDGEWOOD VISTA SENIOR LIVING INC

540 FALCON CREST DR
SPEARFISH, SD 57783-3255

Phone: 605-642-2977
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Assisted Living Facility	310400000X
Alzheimer Center /Dementia Center/Dementia Special Care Unit	311500000X

Indicates primary specialty

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NPI Profile & details for EDGEWOOD VISTA SENIOR LIVING INC

NPI # 1548313992

LBN Legal business name EDGEWOOD VISTA SENIOR LIVING INC

Authorized official ANN WAGNER - (ACCOUNTS RECEIVABLE CLERK)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/19/2007

Last updated 09/11/2025 - About 9 months ago

Identifiers

SD	License #	11073
SD	License #	49736
SD	Medicaid	9570693

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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