MEDICARE: NEW MINNESOTA PURPOSE OF FREEDOM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1184587057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW MINNESOTA PURPOSE OF FREEDOM

Provider Business Mailing Address
First Line	:	110 E 18TH ST APT 107
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403-3998
Country	:	US
Telephone Number	:	612-403-2294
Fax Number	:

Provider Business Practice Location Address
First Line	:	705 42ND AVE N STE 205
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55412-1711
Country	:	US
Telephone Number	:	612-403-2294
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT AND FOUNDER
Name	:	UBAH ADEN MOHAMUD
Credential	:	CPRS
Telephone Number	:	612-403-2294

Provider Enumeration Date	:	12/06/2025
Last Update Date	:	12/06/2025

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Directions to “NEW MINNESOTA PURPOSE OF FREEDOM ” Practice Location

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