BOULDER PONDS SENIOR LIVING, LAKE ELMO

provider_name-BOULDER PONDS SENIOR LIVING

physical_address- 192 JADE TRAIL NORTH

physical_city-LAKE ELMO

physical_state -MN

physical_zip- 55042

county_name-WASHINGTON

telephone- 6124312430

adminstrator/authorized_agent- CAITRIN HOGAN

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 37071

license_number- 423374

medicare_number-

mn_classification- ASSISTED LIVING FACILITY DEMENTIA CARE

federal_classification-

hcbs_designation-

hosp-N

alf-115

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

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