CEDAR LAKE LODGE, INC.

Intermediate Care Facility, Mental Illness

Code: 310500000X

Nursing Facility/Intermediate Care Facility

Code: 313M00000X

Intermediate Care Facility, Intellectual Disabilities

Code: 315P00000X

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Code: 320900000X

Respite Care — Respite Care, Intellectual and/or Developmental Disabilities, Child

Code: 385HR2060X