Pineridge Homes Inc., Moose Lake

License Number- 1068719

License Type-Home and Community Based Services – Community Residential Setting

Name of Program-  Pineridge Homes Inc.

Website-  

Address- 4480 E Konieska Rd, Moose Lake, MN 55767-9432

County -Carlton

Phone-(218) 485-4196

License Status-   Active

License Holder -Pine Ridge Homes, Inc,

Capacity-   4

Type Of License-  This community residential setting license is a satellite operating under 245D-HCBS Program License Number 1068718; and providing Community Residential Setting: Foster Care services or supported living services

Restrictions-None

Services-       

Licensing Authority-  Carlton County Public Health & Human Services

Initial Effective Date-  7/1/2014