| Banner Health Centers Llc | |
|
4310 N Woodgate Ln Eagan MN 55122-2277 | |
| (206) 886-7771 | |
| Not Available |
| Full Name | Banner Health Centers Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4310 N Woodgate Ln, Eagan, Minnesota |
| Authorized Official Name and Position | Mohamed Abdulle (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2068867771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Health Centers Llc 4310 N Woodgate Ln Eagan MN 55122-2277 Ph: (206) 886-7771 | Banner Health Centers Llc 4310 N Woodgate Ln Eagan MN 55122-2277 Ph: (206) 886-7771 |
| NPI Number | 1710675277 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 09/19/2023 |
| Certification Date | 09/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710675277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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