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EDGEWOOD KALISPELL SENIOR LIVING LLC NPI 1720246879


NPI Information

NPI: 1720246879
Provider Name: EDGEWOOD KALISPELL SENIOR LIVING LLC
Classification: Assisted Living Facility - 3104A0630X
Entity Type: Organization

Specialization: Assisted Living, Behavioral Disturbances

CLIA Number: 27D1058156

Address:
141 INTERSTATE LN
KALISPELL, MT
ZIP 59901
Phone: (406) 755-3240
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EDGEWOOD KALISPELL SENIOR LIVING LLC is an assisted living and behavioral disturbances assisted living facility in Kalispell, MT. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. EDGEWOOD KALISPELL SENIOR LIVING LLC NPI is 1720246879. The provider is registered as an organization entity type.

The provider's business location address is:

141 INTERSTATE LN
KALISPELL, MT
ZIP 59901-877
Phone: (406) 755-3240
Fax: (406) 755-3249

The provider's authorized official is Brett Wilkening .
The authorized official title is Accounts Receivable and has the following contact phone number (701) 738-2000.

The CLIA number assigned to this NPI record is 27D1058156 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/27/2008 and was last updated on 5/27/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13104A0630XAssisted Living FacilityAssisted Living, Behavioral Disturbances11325MONTANAYes

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: 11/14/2023

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