Organization
BOKA HAVEN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETTAFA BOKA LALD (CEO/LALD)
(651) 350-2840
Entity
Organization
Contact information
Practice address
5251 386TH STREET, NORTH BRANCH, MN 55056
(651) 350-2840
Mailing address
912 104TH LN NE, BLAINE, MN 55434-1561
(651) 350-2840
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/19/2024
Last updated
04/19/2024
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