AMIRA CHOICE FOREST LAKE, FOREST LAKE

provider_name-AMIRA CHOICE FOREST LAKE

physical_address- 231 BROADWAY AVENUE WEST

physical_city-FOREST LAKE

physical_state -MN

physical_zip- 55025

county_name-WASHINGTON

telephone- 6514642709

adminstrator/authorized_agent- BRENDA JOHNSON

license_type-  For-Profit Corporation

swing_status-

hfid- 31808

license_number- 424472

medicare_number-

mn_classification- ASSISTED LIVING FACILITY DEMENTIA CARE

federal_classification-

hcbs_designation-

hosp-N

alf-122

https://www.health.state.mn.us/facilities/regulation/assistedliving/index.html

https://www.revisor.mn.gov/statutes/cite/144G.91