SUPPORTIVE LIVING LLC, BURNSVILLE

provider_name-SUPPORTIVE LIVING LLC

physical_address- 3409 WEST PARK DRIVE

physical_city-BURNSVILLE

physical_state -MN

physical_zip- 55306

county_name-DAKOTA

telephone- 6125322029

adminstrator/authorized_agent- HODAN JIMALE

license_type-  LIMITED LIABILITY COMPANY

swing_status-

hfid- 41272

license_number- 419207

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