EVYGABS HEALTHCARE SYSTEMS LLC, FOREST LAKE

provider_name-EVYGABS HEALTHCARE SYSTEMS LLC

physical_address- 20604 ENFIELD AVENUE NORTH

physical_city-FOREST LAKE

physical_state -MN

physical_zip- 55025

county_name-WASHINGTON

telephone- 6514928643

adminstrator/authorized_agent- GABRIEL MBA

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 36395

license_number- 421100

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