NPI age
12 years
Enumerated 2013-10-23
● Active Type 2 · Organization
Edgewood Fruitland Senior Living Llc
Edgewood Fruitland Senior Living Llc is 1 of 201 assisted living facility organizations in Idaho.
Primary specialty
Assisted Living Facility
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Dybwad
Vp Of Finance
Last NPPES update
2022-08-19
Source: monthly bulk 2026-05
How this organization compares
Across 201 active assisted living facility providers in Idaho.
NPI age
12 years
↑ 7 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2013 → 2026
2013-10Enumerated in NPPES
2013
2026
Where they practice
Primary practice location
1255 Allen Ave
Fruitland, ID 836192704
Mailing address
Po Box 13238
Grand Forks, ND 58208
Authorized official
John Dybwad
Vp Of Finance
📞 7017575422
Specialties
-
Assisted Living Facility PrimaryA 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.
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.