PINE TREE RESIDENTIAL CARE INC, CHAMPLIN

provider_name-PINE TREE RESIDENTIAL CARE INC

physical_address- 11881 UTAH AVE N

physical_city-CHAMPLIN

physical_state -MN

physical_zip- 55316

county_name-HENNEPIN

telephone- 6124504105

adminstrator/authorized_agent- MUHSIN SUGULE

license_type-  CORPORATION

swing_status-

hfid- 42143

license_number- 422606

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