LAKE MINNETONKA SHORES, SPRING PARK

provider_name-LAKE MINNETONKA SHORES

physical_address- 4559 SHORELINE DRIVE

physical_city-SPRING PARK

physical_state -MN

physical_zip- 55384

county_name-HENNEPIN

telephone- 9524714001

adminstrator/authorized_agent- MARK PEDERSON

license_type-  Non Profit Limited Liability Company

swing_status-

hfid- 20219

license_number- 423098

medicare_number-

mn_classification- ASSISTED LIVING FACILITY DEMENTIA CARE

federal_classification-

hcbs_designation-

hosp-N

alf-77

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

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