PRIME HOME ALLIANCE LLC, BURNSVILLE

provider_name-PRIME HOME ALLIANCE LLC

physical_address- 2305 TERRACE DRIVE

physical_city-BURNSVILLE

physical_state -MN

physical_zip- 55337

county_name-DAKOTA

telephone- 6124069629

adminstrator/authorized_agent- AMAL ODAWA

license_type-  LIMITED LIABILITY COMPANY

swing_status-

hfid- 41944

license_number- 421935

medicare_number-

mn_classification- PROVISIONAL 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