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EDGEWOOD MITCHELL LLC
NPI 1770004996
Assisted Living Facility in Mitchell, SD

Active since June 28, 2017CLIA 43D2137891 · Waiver
501 EAST SPRUCE STREET, MITCHELL, SD 57301(701) 738-2000 Get Directions Write a Review

NPPES record last updated: June 28, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Edgewood Mitchell Llc NPPES

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

EDGEWOOD MITCHELL LLC (NPI 1770004996) is a healthcare organization registered as an assisted living facility in Mitchell, South Dakota and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through October 4, 2027 and lists Rex Carlson, Exec Vp, Cfo, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1770004996
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEDGEWOOD MITCHELL LLC
Location Address501 EAST SPRUCE STREETMitchell, SD 57301
Mailing Address322 Demers Ave Ste 500Grand Forks, ND 58201 · (701) 757-5410 · Fax (701) 738-2001
Phone(701) 738-2000
Organization SubpartNo
Authorized OfficialRex CarlsonExec Vp, Cfo, Treasurer · (701) 757-5463
Enumeration DateJune 28, 2017
✔ NPI 1770004996 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.

501 EAST SPRUCE STREET, Mitchell, SD 57301
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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 43D2137891

Edgewood Mitchell LLC · Mitchell, SD
Active · expires Oct 4, 2027
CLIA Number43D2137891
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 5, 2025
Certificate Expiration DateOctober 4, 2027
Laboratory DirectorJackie Wenz
Laboratory Phone(605) 996-2730
Laboratory LocationEdgewood Mitchell LLC501 East Spruce St, Mitchell, SD 57301
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Mitchell LLC's NPI number?

The NPI number for Edgewood Mitchell LLC is 1770004996. It was assigned to this organization in the NPPES registry on June 28, 2017.

Where is Edgewood Mitchell LLC located?

Edgewood Mitchell LLC is located at 501 East Spruce Street, Mitchell, SD 57301. The listed phone number is (701) 738-2000.

What is Edgewood Mitchell LLC's specialty?

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

Does Edgewood Mitchell LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 43D2137891) is associated with this NPI, valid through October 4, 2027. 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 Mitchell LLC was last updated on June 28, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.