EDGEWOOD MAY CREEK LLC NPI 1053794362

NPI Information

  • NPI: 1053794362
  • Provider Name: EDGEWOOD MAY CREEK LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: MAY CREEK
  • CLIA Number: 24D1062276
  • Address: 303 10TH STREET SOUTH
    WALKER, MN
    ZIP 56484
  • Phone: (701) 757-5465

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NPI Details

EDGEWOOD MAY CREEK LLC is an assisted living facility in Walker, MN. 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 MAY CREEK LLC NPI is 1053794362. The provider is registered as an organization entity type.
The provider Is Doing Business As May Creek.

The provider's business location address is:

303 10TH STREET SOUTH
WALKER, MN
ZIP 56484
Phone: (701) 757-5465

The provider's authorized official is Rex Carlson .
The authorized official title is Cfo and has the following contact phone number (701) 757-5465.

The CLIA number assigned to this NPI record is 24D1062276 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/6/2015 and was last updated on 7/6/2015.

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
1310400000XAssisted Living FacilityYes

What is NPI?

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This page was last updated on: 11/21/2025

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