Healthcare Provider Details

I. General information

NPI: 1487525341
Provider Name (Legal Business Name): ABRIVA HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2738 WINNETKA AVE N # 200G
MINNEAPOLIS MN
55427-2850
US

IV. Provider business mailing address

2738 WINNETKA AVE N UNIT 200G
NEW HOPE MN
55427-2850
US

V. Phone/Fax

Practice location:
  • Phone: 763-237-6351
  • Fax: 763-237-6380
Mailing address:
  • Phone: 763-237-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ABDIRIHAMAN ABDULKADIR
Title or Position: DIRECTOR
Credential:
Phone: 763-237-6331