MOOSE LAKE VILLAGE ASSISTED LI, MOOSE LAKE

provider_name-MOOSE LAKE VILLAGE ASSISTED LI

physical_address- 300 TALBOT DRIVE

physical_city-MOOSE LAKE

physical_state -MN

physical_zip- 55767

county_name-CARLTON

telephone- 2184858795

adminstrator/authorized_agent- JULIANNE FRIES

license_type-  Non Profit Limited Liability Company

swing_status-

hfid- 30390

license_number- 422911

medicare_number-

mn_classification- ASSISTED LIVING FACILITY

federal_classification-

hcbs_designation-

hosp-N

alf-22

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

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