Healthcare Provider Details

I. General information

NPI: 1992624464
Provider Name (Legal Business Name): BRAVE HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8030 OLD CEDAR AVE S STE 200
BLOOMINGTON MN
55425-1215
US

IV. Provider business mailing address

8030 OLD CEDAR AVE S STE 200
BLOOMINGTON MN
55425-1215
US

V. Phone/Fax

Practice location:
  • Phone: 612-457-3800
  • Fax:
Mailing address:
  • Phone: 612-457-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ABDIRAHMAN MOHAMED
Title or Position: MANAGER
Credential:
Phone: 612-457-3800