ST JUDE HOME HEALTH LLC, CHAMPLIN

provider_name-ST JUDE HOME HEALTH LLC

physical_address- 6426 109TH PLACE NORTH

physical_city-CHAMPLIN

physical_state -MN

physical_zip- 55316

county_name-HENNEPIN

telephone- 6124600018

adminstrator/authorized_agent- DOROTHY MING’ATE

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 36618

license_number- 419743

medicare_number-

mn_classification- ASSISTED LIVING FACILITY

federal_classification-

hcbs_designation-

hosp-N

alf-4

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

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