Healthcare Provider Details

I. General information

NPI: 1265290811
Provider Name (Legal Business Name): EMBRACE HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 STINSON BLVD NE STE 314
SAINT ANTHONY MN
55421-3424
US

IV. Provider business mailing address

4001 STINSON BLVD NE STE 314
SAINT ANTHONY MN
55421-3424
US

V. Phone/Fax

Practice location:
  • Phone: 612-503-2823
  • Fax: 612-352-9269
Mailing address:
  • Phone: 612-503-2823
  • Fax: 612-352-9269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AHMED M ABDILAHI
Title or Position: CEO
Credential:
Phone: 612-503-2823