EDGEWOOD THE COMMONS
NPI 1083089825
Assisted Living Facility in Watertown, SD

Q: What is Edgewood Prairie Crossings Watertown Il LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since December 04, 2015CLIA 43D2110844 · Waiver

901 14TH AVE NE, WATERTOWN, SD 57201(605) 882-3084 Get Directions Write a Review

NPPES record last updated: December 4, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Edgewood The Commons NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDGEWOOD THE COMMONS (NPI 1083089825) is a healthcare organization registered as an assisted living facility in Watertown, South Dakota and active in the NPI registry since December 2015. The organization holds a CLIA Waiver certificate valid through March 23, 2028 and lists Rex Carlson, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1083089825

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameEDGEWOOD PRAIRIE CROSSINGS WATERTOWN IL LLC

Location Address901 14TH AVE NEWatertown, SD 57201-6817

Mailing Address322 Demers Ave Ste 500Grand Forks, ND 58201-4799 · (701) 757-5410

Phone(605) 882-3084

Organization SubpartNo

Authorized OfficialRex CarlsonTreasurer · (701) 757-5463

Enumeration DateDecember 4, 2015

✔ NPI 1083089825 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

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.

901 14TH AVE NE, Watertown, SD 57201

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Other Names 1

Other NameEdgewood The Commons

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 43D2110844

Edgewood Prairie Crossings Watertown Il LLC · Watertown, SD

Active · expires Mar 23, 2028

CLIA Number43D2110844

Laboratory TypeAssisted Living Facility

Certificate Effective DateMarch 24, 2026

Certificate Expiration DateMarch 23, 2028

Laboratory DirectorCarrie Kwasniewski

Laboratory Phone(605) 882-3084

Laboratory LocationEdgewood Prairie Crossings Watertown Il LLC901 14th Ave Northeast, Watertown, SD 57201

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH MARIE ZEMLICKA OT

Occupational Therapist