EXECUTIVE HEALTH SERVICES LLC, ST PAUL

provider_name-EXECUTIVE HEALTH SERVICES LLC

physical_address- 1847 IVY AVENUE EAST

physical_city-ST PAUL

physical_state -MN

physical_zip- 55119

county_name-RAMSEY

telephone- 6129863656

adminstrator/authorized_agent- MOHAMED AHMED

license_type-  For-Profit Limited Liability Company

swing_status-

hfid- 39226

license_number- 421927

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