Brask Haven Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

330813 Issued in MN

Legal business name

BRASK HAVEN INC

Practice address

31274 Julliard St NE
North Branch, MN 55056-6546

Phone

(651) 674-7433

Fax

(651) 237-0563

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Ettafa Boka

Title

Co-Owner

Phone

(651) 448-9940

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1780765487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31274 JULLIARD ST NE",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566546",
            "telephone_number": "651-674-7433",
            "fax_number": "651-237-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31274 JULLIARD ST NE",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566546",
            "telephone_number": "651-674-7433",
            "fax_number": "651-237-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRASK HAVEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "BOKA",
        "authorized_official_first_name": "ETTAFA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "651-448-9940"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "330813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHCP ID",
            "identifier": "216303900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beasytrans Systems, Inc.
• Bickford of North Branch, LLC
• Boka Haven Inc
• Kevin Joseph Bovitz, D.C.
• Branch Mental Health PLLC
• Breanna Herbst Counseling
• Karyn Ann Brinker, MSN, APRN, FNP-BC
• Natalia O. Brown Hals
• Julia Buntrock
• Cambridge Eye Associates, P.a. (North Branch Eye Associates)

• Assisted Living Facility in North Branch, MN
• Providers in North Branch, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.