EDGEWOOD WATERTOWN MC 2 LLC NPI 1326516501

NPI Information

  • NPI: 1326516501
  • Provider Name: EDGEWOOD WATERTOWN MC 2 LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • CLIA Number: 43D2110844
  • Address: 225 14 AVE NE
    WATERTOWN, SD
    ZIP 57201
  • Phone: (701) 757-5410

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NPI Details

EDGEWOOD WATERTOWN MC 2 LLC is an assisted living facility in Watertown, 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 WATERTOWN MC 2 LLC NPI is 1326516501. The provider is registered as an organization entity type.

The provider's business location address is:

225 14 AVE NE
WATERTOWN, SD
ZIP 57201
Phone: (701) 757-5410
Fax: (701) 738-2001

The provider's authorized official is Trudi L Mosteller .
The authorized official title is Regional Controller and has the following contact phone number (701) 757-5410.

The CLIA number assigned to this NPI record is 43D2110844 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/6/2018 and was last updated on 11/6/2018.

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?

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: 11/21/2025

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