Organization
BRAINZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULINUS CHAH FULTANG (OWNER)
(763) 670-5000
Entity
Organization
Contact information
Practice address
7691 CENTRAL AVE NE, SUITE 102, FRIDLEY, MN 55432-3560
(763) 670-5000
Mailing address
1160 S. DELLWOOD STREET, APT 106, CAMBRIDGE, MN 55008
(763) 670-5000
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/20/2013
Last updated
05/20/2013
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