NAME: Fourth Ave Homes Inc
CITY: Spicer
COUNTY: Kandiyohi
PHONE: (320) 796-5753
LICENSE HOLDER: Fourth Avenue Homes Inc
CAPACITY: 4
LICENSE TYPE: Home and Community Based Services – Community Residential Setting
TYPE OF LICENSE: This community residential setting license is a satellite operating under 245D-HCBS Program License Number 1068742; and providing Community Residential Setting: Respite care services, out-of-home; Crisis respite, out-of-home; Foster Care services or supported living services * Certification: Adult Mental Health Certification – Site/Service Specific
LICENSING AUTHORITY: Kandiyohi County Family Service Dept