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General NPI Number Information
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NPI Number | 1184587057
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Entity Type | Organization
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Legal Business Name | NEW MINNESOTA PURPOSE OF FREEDOM
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Dates
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Enumeration Date | 12/06/2025
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 705 42ND AVE N STE 205
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City | MINNEAPOLIS
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State | MN
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Zip | 55412-1711
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Country | US
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Telephone | 612-403-2294
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Fax |
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Provider Business Mailing Address
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Address Line | 110 E 18TH ST APT 107
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City | MINNEAPOLIS
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State | MN
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Zip | 55403-3998
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Country | US
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Telephone | 612-403-2294
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND FOUNDER
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Name | UBAH ADEN MOHAMUD
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Credential | CPRS
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Telephone | 612-403-2294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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