CUSTOMIZE LIVING, MINNEAPOLIS

provider_name-CUSTOMIZE LIVING

physical_address- 3237 2ND AVENUE SOUTH

physical_city-MINNEAPOLIS

physical_state -MN

physical_zip- 55408

county_name-HENNEPIN

telephone- 6129872629

adminstrator/authorized_agent- SULEBAN HUSSEIN

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 39269

license_number- 420680

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