EDGEWOOD HERMANTOWN I SR LVG, HERMANTOWN

provider_name-EDGEWOOD HERMANTOWN I SR LVG

physical_address- 4195 WESTBERG ROAD

physical_city-HERMANTOWN

physical_state -MN

physical_zip- 55811

county_name-SAINT LOUIS

telephone- 2187238905

adminstrator/authorized_agent- BRIAN HASELMAN

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 30824

license_number- 421783

medicare_number-

mn_classification- ASSISTED LIVING FACILITY DEMENTIA CARE

federal_classification-

hcbs_designation-

hosp-N

alf-226

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

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