BROADWELL PLYMOUTH SENIOR LIVI, PLYMOUTH

provider_name-BROADWELL PLYMOUTH SENIOR LIVI

physical_address- 3025 NORTH HARBOR LANE

physical_city-PLYMOUTH

physical_state -MN

physical_zip- 55447

county_name-HENNEPIN

telephone- 9523585100

adminstrator/authorized_agent- HEIDI ELLIOTT

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 37869

license_number- 423920

medicare_number-

mn_classification- ASSISTED LIVING FACILITY DEMENTIA CARE

federal_classification-

hcbs_designation-

hosp-N

alf-130

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

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