Edgewood Fruitland Senior Living LLC
NPI 1063840353ActiveOrganization· Assisted Living Facility· Fruitland, ID
Assisted Living Facility in Fruitland, Idaho, registered in NPPES in October 2013. The authorized official on file is John Dybwad, Vp Of Finance.
Overview
| NPI | 1063840353 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 23, 2013 |
| Last updated in NPPES | Aug 19, 2022 |
| Certified by provider | Aug 19, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Assisted Living Facility Primary | 310400000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|