License Number- 1123174
License Type-Home and Community Based Services – Community Residential Setting
Name of Program- Universal Health Services LLC
Website-
Address- 10324 PORTLAND AVE S, Bloomington, MN 55420-5434
County -Hennepin
Phone-(612) 715-8054
License Status- Active
License Holder -Universal Health Services LLC
Capacity- 4
Type Of License- This community residential setting license is a satellite operating under 245D-HCBS Program License Number 1113042; and providing Community Residential Setting: Foster Care services or supported living services
Restrictions-None
Services-
Licensing Authority- Hennepin County Human Services & Public Health Dept
Initial Effective Date- 3/1/2024
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