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

Edgewood Fruitland Senior Living LLC

Organization Assisted Living Facility · NPI 1063840353

Edgewood Fruitland Senior Living LLC is an Assisted Living Facility in Fruitland, Idaho. Registered with an NPI since 2013.

In the registry since
2013
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1255 Allen Ave
Fruitland, ID 83619-2704
Phone: (208) 452-5163
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X

Record details

NPI number1063840353
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Dybwad — Vp Of Finance · (701) 757-5422
NPI enumeratedOctober 23, 2013
Last updated in NPPESAugust 19, 2022
Certification dateAugust 19, 2022
Mailing addressPo Box 13238, Grand Forks, ND 58208