DOOR OF GRACE LLC, BLAINE

provider_name-DOOR OF GRACE LLC

physical_address- 1157 129TH AVE NE

physical_city-BLAINE

physical_state -MN

physical_zip- 55434

county_name-ANOKA

telephone- 6122721796

adminstrator/authorized_agent- DORETTE MEFEUNE

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 41371

license_number- 422604

medicare_number-

mn_classification- PROVISIONAL 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