All Medicaid billing entities listing AYCOCK, LAKESIA (ADMINISTRATION/MHP) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Minnesota | 1 | $16K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | DIVINE LEGACY | BROOKLYN CENTER, MN | Corporate Health Clinic/Center | $16K |