License Number- 1115143
License Type-Home and Community Based Services – Community Residential Setting
Name of Program- Entrusted Home Healthcare
Website-
Address- 309 13TH AVE S, SOUTH SAINT PAUL, MN 55075-2532
County -Dakota
Phone-(651) 332-4220
License Status- Active
License Holder -Korme Uka Koji
Capacity- 4
Type Of License- This community residential setting license is a satellite operating under 245D-HCBS Program License Number 1092600; and providing Community Residential Setting: Foster Care services or supported living services
Restrictions-None
Services-
Licensing Authority- Dakota County Community Services
Initial Effective Date- 8/1/2022
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