EDGEWOOD GRAND FORKS LLC
NPI 1386390672
Assisted Living Facility in Grand Forks, ND

Active since February 24, 2022CLIA 35D2254548 · Waiver
1800 47TH AVE S, GRAND FORKS, ND 58201(701) 738-2000(701) 738-2001 Get Directions Write a Review

NPPES record last updated: September 4, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 4, 2024, Feb 24, 2022 (2 updates tracked since 2022).

About Edgewood Grand Forks Llc NPPES

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

EDGEWOOD GRAND FORKS LLC (NPI 1386390672) is a healthcare organization registered as an assisted living facility in Grand Forks, North Dakota and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through March 3, 2028 and lists John Dybwad, Vp Finance/budget, as its authorized official.

NPPES Registry Identity

NPI1386390672
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDGEWOOD GRAND FORKS LLC
Location Address1800 47TH AVE SGrand Forks, ND 58201
Mailing AddressPo Box 13238Grand Forks, ND 58208-3238 · (701) 738-2000 · Fax (701) 738-2001
Fax(701) 738-2001
Organization SubpartNo
Authorized OfficialJohn DybwadVp Finance/budget · (701) 757-5422
Enumeration DateFebruary 24, 2022
Last NPPES UpdateSeptember 4, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 4, 2024
NPI 1386390672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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.

Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X
1800 47TH AVE S, Grand Forks, ND 58201

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 35D2254548

Edgewood Grand Forks LLC · Grand Forks, ND
Active · expires Mar 3, 2028
CLIA Number35D2254548
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 4, 2026
Certificate Expiration DateMarch 3, 2028
Laboratory DirectorDiana Blumhorst
Laboratory Phone(701) 215-6527
Laboratory LocationEdgewood Grand Forks LLC1800 47th Ave S, Grand Forks, ND 58201
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Alzheimer Center (Dementia Center)
1800 47TH AVE S
GRAND FORKS, ND 58201

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgewood Grand Forks LLC's NPI number?

The NPI number for Edgewood Grand Forks LLC is 1386390672. It was assigned to this organization in the NPPES registry on February 24, 2022.

Where is Edgewood Grand Forks LLC located?

Edgewood Grand Forks LLC is located at 1800 47th Ave S, Grand Forks, ND 58201. The listed phone number is (701) 738-2000.

What is Edgewood Grand Forks LLC's specialty?

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

Does Edgewood Grand Forks LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 35D2254548) is associated with this NPI, valid through March 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Edgewood Grand Forks LLC was last updated on September 4, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.