Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edgewood Blaine LLC

Organization Assisted Living Facility · NPI 1396167953

Edgewood Blaine LLC is an Assisted Living Facility in Blaine, Minnesota. Licensed in Minnesota. Registered with an NPI since 2014.

Licensed in
MN
In the registry since
2014
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12450 Cloud Dr NE
Blaine, MN 55449-6226
Phone: (763) 754-1723
Fax: (763) 754-1728
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence 29791 (MN)
Assisted Living Facility Taxonomy 310400000X · Licence 29941 (MN)

Record details

NPI number1396167953
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ronald Whetter — Vp Of Finance/Budget · (701) 757-5465
NPI enumeratedJanuary 15, 2014
Last updated in NPPESJanuary 15, 2014
Mailing address322 Demers Ave, Suite 500, Grand Forks, ND 58201-4754

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