Healthcare Provider Details

I. General information

NPI: 1508758848
Provider Name (Legal Business Name): MAX EFFORT RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10113 PORTLAND AVE S
MINNEAPOLIS MN
55420-5050
US

IV. Provider business mailing address

10113 PORTLAND AVE S
MINNEAPOLIS MN
55420-5050
US

V. Phone/Fax

Practice location:
  • Phone: 617-596-1210
  • Fax: 617-596-1210
Mailing address:
  • Phone: 617-596-1210
  • Fax: 617-596-1210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State

VIII. Authorized Official

Name: MR. ABDIRAHMAN ADAM ABDI
Title or Position: DIRECTOR, OWNER
Credential:
Phone: 617-596-1210