CRYSTAL EDGE LLC, BROOKLYN PARK

provider_name-CRYSTAL EDGE LLC

physical_address- 9119 REGENT PARKWAY

physical_city-BROOKLYN PARK

physical_state -MN

physical_zip- 55443

county_name-HENNEPIN

telephone- 6124592724

adminstrator/authorized_agent- HAJA UCHE

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 40135

license_number- 421235

medicare_number-

mn_classification- ASSISTED LIVING FACILITY

federal_classification-

hcbs_designation-

hosp-N

alf-5

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

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