La Costa Health Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LA COSTA HEALTH SERVICES LLC

Practice address

2817 Anthony LN S Ste 106
St Anthony, MN 55418-2489

Phone

(612) 788-4290

Fax

(612) 788-4290

NPI assigned

Jun 23, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mahamud Mahad Abdi, MASTER'S DEGREE

Title

Director

Phone

(619) 865-3475

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1710338462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ANTHONY LN S STE 106",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554182489",
            "telephone_number": "612-788-4290",
            "fax_number": "612-788-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ANTHONY LN S STE 106",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554182489",
            "telephone_number": "612-788-4290",
            "fax_number": "612-788-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA COSTA HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "ABDI",
        "authorized_official_first_name": "MAHAMUD",
        "authorized_official_middle_name": "MAHAD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "619-865-3475",
        "authorized_official_credential": "MASTER'S DEGREE"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.