Provide Care Inc. Roosevelt, North Branch

License Number- 1071390

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

Name of Program-  Provide Care Inc. Roosevelt

Website-  

Address- 40875 Fenian Way, North Branch, MN 55056-0000

County -Chisago

Phone-(651) 674-4671

License Status-   Active

License Holder -Provide Care Inc

Capacity-   4

Type Of License-  This community residential setting license is a satellite operating under 245D-HCBS Program License Number 1071387; and providing Community Residential Setting: Crisis respite, out-of-home; Foster Care services or supported living services

Restrictions-None

Services-       

Licensing Authority-  Chisago County Health & Human Services

Initial Effective Date-  7/1/2014