| La Costa Health Services Llc | |
|
2817 Anthony Ln S Ste 106 St Anthony MN 55418-2489 | |
| (612) 788-4290 | |
| (612) 788-4290 |
| Full Name | La Costa Health Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2817 Anthony Ln S Ste 106, St Anthony, Minnesota |
| Authorized Official Name and Position | Mahamud Mahad Abdi (DIRECTOR) |
| Authorized Official Contact | 6198653475 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Costa Health Services Llc 2817 Anthony Ln S Ste 106 St Anthony MN 55418-2489 Ph: (612) 788-4290 | La Costa Health Services Llc 2817 Anthony Ln S Ste 106 St Anthony MN 55418-2489 Ph: (612) 788-4290 |
| NPI Number | 1710338462 |
|---|---|
| Provider Enumeration Date | 06/23/2016 |
| Last Update Date | 06/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710338462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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