| Edina Health Company | |
|
2365 Louisiana Ave N Minneapolis MN 55427-3632 | |
| (612) 876-7414 | |
| (612) 435-1225 |
| Full Name | Edina Health Company |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2365 Louisiana Ave N, Minneapolis, Minnesota |
| Authorized Official Name and Position | Usama Liban Hassan (OWNER / PRESIDENT) |
| Authorized Official Contact | 6128767414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edina Health Company 2365 Louisiana Ave N Minneapolis MN 55427-3632 Ph: (612) 876-7414 | Edina Health Company 2365 Louisiana Ave N Minneapolis MN 55427-3632 Ph: (612) 876-7414 |
| NPI Number | 1093432395 |
|---|---|
| Provider Enumeration Date | 10/26/2022 |
| Last Update Date | 10/26/2022 |
| Certification Date | 10/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093432395 | NPI | - | NPPES |
| 8383431 | Other | MN | MN DEPARTMENT OF REVENUE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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