NPI: 1770004996 · MITCHELL, SD 57301 · Assisted Living Facility · NPI assigned 06/28/2017
| Authorized Official | CARLSON, REX (EXEC VP, CFO, TREASURER) |
| NPI Enumeration Date | 06/28/2017 |
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 PRAIRIE CROSSINGS WATERTOWN IL LLC | WATERTOWN | SD | $13K |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 35 | $16K |
| 2023 | 56 | $70K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2031 | Assisted living; waiver, per diem | 91 | 73 | $86K |