Brainz LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BRAINZ LLC

Practice address

7691 Central Ave NE
Suite 102
Fridley, MN 55432-3560

Phone

(763) 670-5000

NPI assigned

May 20, 2013

Last updated

May 20, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paulinus Chah Fultang

Title

Owner

Phone

(763) 670-5000

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369008000000",
    "number": "1649616590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 S. DELLWOOD STREET",
            "address_2": "APT 106",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "55008",
            "telephone_number": "763-670-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7691 CENTRAL AVE NE",
            "address_2": "SUITE 102",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323560",
            "telephone_number": "763-670-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-20",
        "last_updated": "2013-05-20",
        "status": "A",
        "authorized_official_last_name": "FULTANG",
        "authorized_official_first_name": "PAULINUS",
        "authorized_official_middle_name": "CHAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-670-5000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Kah Min Bong, MD
• Lori Patricia Borchardt, RPH
• Jenna Borkenhagen
• Saleh Botan
• Alexander Talbot Boyer
• Joseph Michael Brandt, DO
• Kathrine Linn Brathen, MA, L.P.
• Ashley Brausen, DPT
• Jeffrey L Brenna, PHARMD
• Ellen Brice

• Home Health Agency in Fridley, MN
• Providers in Fridley, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.