Organization
BRASK HAVEN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETTAFA BOKA (CO-OWNER)
(651) 448-9940
Entity
Organization
Contact information
Practice address
31274 JULLIARD ST NE, NORTH BRANCH, MN 55056-6546
(651) 674-7433
(651) 237-0563
Mailing address
31274 JULLIARD ST NE, NORTH BRANCH, MN 55056-6546
(651) 674-7433
(651) 237-0563
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
330813
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216303900
MHCP ID
MN
Enumeration date
10/18/2006
Last updated
05/06/2024
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