Healthcare Provider Details

I. General information

NPI: 1316892128
Provider Name (Legal Business Name): HODAN ADAN ABDULLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 TAFT ST NE
MINNEAPOLIS MN
55413-2814
US

IV. Provider business mailing address

14408 ALABAMA AVE S
SAVAGE MN
55378-2859
US

V. Phone/Fax

Practice location:
  • Phone: 646-750-4838
  • Fax:
Mailing address:
  • Phone: 612-483-9427
  • 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 StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: