INNOVATIVE ASSISTED LIVING INC, MAPLE GROVE

provider_name-INNOVATIVE ASSISTED LIVING INC

physical_address- 10005 101ST AVE N

physical_city-MAPLE GROVE

physical_state -MN

physical_zip- 55369

county_name-HENNEPIN

telephone- 6124321472

adminstrator/authorized_agent- MUKHTAR MUSA

license_type-  For-Profit Corporation

swing_status-

hfid- 42397

license_number- 422707

medicare_number-

mn_classification- PROVISIONAL 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