Organization
EDINA HEALTH COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
USAMA LIBAN HASSAN (OWNER / PRESIDENT)
(612) 876-7414
Entity
Organization
Contact information
Practice address
2233 UNIVERSITY AVE W STE 421, SAINT PAUL, MN 55114-1629
(651) 649-4444
(651) 649-4445
Mailing address
2233 UNIVERSITY AVE W STE 421, SAINT PAUL, MN 55114-1629
(651) 649-4444
(651) 649-4445
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8383431
MN DEPARTMENT OF REVENUE
MN
Enumeration date
10/26/2022
Last updated
11/28/2024
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