EDGEWOOD GREEN LEAF FLANDREAU NPI 1720376114

NPI Information

NPI: 1720376114
Provider Name: EDGEWOOD GREEN LEAF FLANDREAU
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 43D0988587

Address:
800 S WIND ST
FLANDREAU, SD
ZIP 57028
Phone: (605) 997-2775
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EDGEWOOD GREEN LEAF FLANDREAU is an assisted living facility in Flandreau, SD. The provider is 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. EDGEWOOD GREEN LEAF FLANDREAU NPI is 1720376114. The provider is registered as an organization entity type.

The provider's business location address is:

800 S WIND ST
FLANDREAU, SD
ZIP 57028-301
Phone: (605) 997-2775
Fax: (605) 997-3859

The provider's authorized official is Ron Whetter .
The authorized official title is Vp Of Budget/finance and has the following contact phone number (701) 738-2000.

The CLIA number assigned to this NPI record is 43D0988587 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/19/2011 and was last updated on 7/19/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		46723	SOUTH DAKOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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