Edgewood Fruitland Senior Living LLC
NPI 1063840353 · Assisted Living Facility · Fruitland, ID
Edgewood Fruitland Senior Living LLC is a Assisted Living Facility organization in Fruitland, ID (NPI 1063840353).
Provider details
- NPI number
- 1063840353
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- John Dybwad, Vp of Finance(701) 757-5422
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2013-10-23
- Last updated
- 2022-08-19
- Certified
- 2022-08-19
Frequently asked questions
- What is Edgewood Fruitland Senior Living LLC's NPI number?
- Edgewood Fruitland Senior Living LLC's National Provider Identifier (NPI) is 1063840353, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Edgewood Fruitland Senior Living LLC?
- Edgewood Fruitland Senior Living LLC is classified in the NPPES registry as Assisted Living Facility (Nursing & Custodial Care Facilities).
- Where is Edgewood Fruitland Senior Living LLC located?
- Edgewood Fruitland Senior Living LLC's practice location on file with NPPES is 1255 Allen Ave, Fruitland, ID 83619-2704.
- What is Edgewood Fruitland Senior Living LLC's phone number?
- The practice phone number listed in the NPPES registry for Edgewood Fruitland Senior Living LLC is (208) 452-5163.
- Who is the authorized official for Edgewood Fruitland Senior Living LLC?
- The authorized official listed on Edgewood Fruitland Senior Living LLC's NPPES record is John Dybwad, Vp of Finance. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Edgewood Fruitland Senior Living LLC's NPI active?
- Yes — Edgewood Fruitland Senior Living LLC's NPI (1063840353) is active in the NPPES registry as of the last update on 2022-08-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.