Dungarvin 76th Ave Fish Lake, Maple Grove

License Number- 1070815

License Type-Home and Community Based Services – Community Residential Setting

Name of Program-  Dungarvin 76th Ave Fish Lake

Website-  

Address- 15160 76th Ave N, Maple Grove, MN 55311-0000

County -Hennepin

Phone-(763) 420-3958

License Status-   Active

License Holder -Dungarvin Minnesota LLC

Capacity-   4

Type Of License-  This community residential setting license is a satellite operating under 245D-HCBS Program License Number 1070806; and providing Community Residential Setting: Foster Care services or supported living services

Restrictions-None

Services-       

Licensing Authority-  Hennepin County Human Services & Public Health Dept

Initial Effective Date-  7/1/2014