TABERNACLE HOME CARE, LINO LAKES

provider_name-TABERNACLE HOME CARE

physical_address- 189 ULMER DRIVE

physical_city-LINO LAKES

physical_state -MN

physical_zip- 55014

county_name-ANOKA

telephone- 6128121907

adminstrator/authorized_agent- LAMESSA BOKA

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 39156

license_number- 421212

medicare_number-

mn_classification- 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