24D2271722 CLIA NUMBER - GOLDEN HEART HOME 3 (ADF GROUP, LLC)

Laboratory Demographics

CLIA Number: 24D2271722

Facility Name: GOLDEN HEART HOME 3 (ADF GROUP, LLC)

Facility Address:
14280 ALLEN DR
SAVAGE, MN
ZIP 55378
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Facility Phone Number: 952 846-9196

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1881241313

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 24D2271722
LAB Type Assisted Living Facility
Facility Name GOLDEN HEART HOME 3 (ADF GROUP, LLC)
Street 14280 ALLEN DR
City SAVAGE
State MN
ZIP 55378
Phone 952 846-9196
CertificateType 4
CertificateEffectiveDate 11/8/2022
CertificateExpirationDate 11/7/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024