MEDICARE: CLEARHAVEN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1538012927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEARHAVEN LLC

Provider Business Mailing Address
First Line	:	5701 SHINGLE CREEK PKWY STE 210G
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-2330
Country	:	US
Telephone Number	:	612-556-3464
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 SHINGLE CREEK PKWY STE 210G
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55430-2330
Country	:	US
Telephone Number	:	612-556-3464
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ABDIRAHMAN KHALIF AHMED
Credential	:
Telephone Number	:	612-556-3464

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “CLEARHAVEN LLC ” Practice Location

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