Organization
LA COSTA HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHAMUD MAHAD ABDI MASTER'S DEGREE (DIRECTOR)
(619) 865-3475
Entity
Organization
Contact information
Practice address
2817 ANTHONY LN S STE 106, ST ANTHONY, MN 55418-2489
(612) 788-4290
(612) 788-4290
Mailing address
2817 ANTHONY LN S STE 106, ST ANTHONY, MN 55418-2489
(612) 788-4290
(612) 788-4290
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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