NPI: 1083089825 · WATERTOWN, SD 57201 · Assisted Living Facility · NPI assigned 12/04/2015
| Authorized Official | CARLSON, REX (TREASURER) |
| NPI Enumeration Date | 12/04/2015 |
Other providers sharing the same authorized official: CARLSON, REX
| Provider | City | State | Total Paid |
|---|---|---|---|
| EDGEWOOD SARTELL LLC | GRAND FORKS | ND | $7.08M |
| EDGEWOOD BAXTER LLC | BAXTER | MN | $2.46M |
| EDGEWOOD JAMESTOWN,LLC | GRAND FORKS | ND | $847K |
| EDGEWOOD MITCHELL LLC | MITCHELL | SD | $86K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 12 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2031 | Assisted living; waiver, per diem | 12 | 12 | $13K |