NPI 1962379404 · live from the CMS NPI Registry
Edgwood Mi Opco LLC
Skilled Nursing Facility in Three Rivers, MI. National Provider Identifier 1962379404, active.
NPI record
| NPI | 1962379404 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 55378 Wilbur Rd, Three Rivers, MI 49093 |
| Practice phone | 732-330-2157 |
| Mailing address | 175 Route 70 Ste 207, Toms River, NJ 08755 |
| Enumerated | October 20, 2025 |
| Last updated | December 10, 2025 |
| Authorized official | Esti Pruzansky, Ar |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.