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EDGEWOOD HERMANTOWN I SENIOR LIVING LLC
NPI 1609050442
Assisted Living Facility in Hermantown, MN

Active since December 27, 2007
4195 WESTBERG RD, HERMANTOWN, MN 55811(701) 738-2000(701) 738-2001 Get Directions Write a Review

NPPES record last updated: May 26, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edgewood Hermantown I Senior Living Llc NPPES

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

EDGEWOOD HERMANTOWN I SENIOR LIVING LLC (NPI 1609050442) is a healthcare organization registered as an assisted living facility in Hermantown, Minnesota and active in the NPI registry since December 2007. The organization lists Ron Whetter, Vp Budget And Finance, as its authorized official.

NPPES Registry Identity

NPI1609050442
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDGEWOOD HERMANTOWN I SENIOR LIVING LLC
Location Address4195 WESTBERG RDHermantown, MN 55811-3916
Mailing Address2850 24th Ave S, Suite 201Grand Forks, ND 58201-5831 · (701) 738-2000 · Fax (701) 738-2001
Phone(701) 738-2000
Fax(701) 738-2001
Organization SubpartNo
Authorized OfficialRon WhetterVp Budget And Finance · (701) 738-2000
Enumeration DateDecember 27, 2007
Last NPPES UpdateMay 26, 2011
✔ NPI 1609050442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MN · 338403
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.
4195 WESTBERG RD, Hermantown, MN 55811
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Other Identifiers 3

Medicaid338387MN
Medicaid338403MN
Medicaid338369MN

Other Providers at the Same Location NPPES 12

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

MATTHEW O'CONNOR
Physical Therapist
4195 WESTBERG RD
HERMANTOWN, MN 55811
St. Louis County (218) 216-9921
CARINGEDGE HOSPICE OF HERMANTOWN LLC
Hospice Care, Community Based
4195 WESTBERG RD
HERMANTOWN, MN 55811
St. Louis County (218) 723-8905
LAURA HOESCHEN DPT
Physical Therapist
4195 WESTBERG RD
HERMANTOWN, MN 55811
St. Louis County (218) 216-9921
AMANDA K WILSON PT
Physical Therapist
4195 WESTBERG RD
HERMANTOWN, MN 55811
St. Louis County (218) 216-9921
RACHEL ANN ANDREWS PT
Physical Therapist
4195 WESTBERG RD
HERMANTOWN, MN 55811
St. Louis County (218) 216-9921
MS. REBECCA MARIE-LEWIS LEE PT
Physical Therapist
4195 WESTBERG RD
HERMANTOWN, MN 55811
St. Louis County (218) 216-9921
CASEY HEADLEE OT
Occupational Therapist
4195 WESTBERG RD
HERMANTOWN, MN 55811
St. Louis County (218) 216-9921
BROOKE KUNKEL PT
Occupational Therapist
4195 WESTBERG RD
HERMANTOWN, MN 55811
St. Louis County (218) 216-9921

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 Hermantown I Senior Living LLC's NPI number?

The NPI number for Edgewood Hermantown I Senior Living LLC is 1609050442. It was assigned to this organization in the NPPES registry on December 27, 2007.

Where is Edgewood Hermantown I Senior Living LLC located?

Edgewood Hermantown I Senior Living LLC is located at 4195 Westberg Rd, Hermantown, MN 55811. The listed phone number is (701) 738-2000.

What is Edgewood Hermantown I Senior Living LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Edgewood Hermantown I Senior Living LLC was last updated on May 26, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.