Organization Active NPI

Fulfilledlyf Care and Community Services LLC

  • In Home Supportive Care Agency
  • Brooklyn Center, MN
National Provider Identifier
1932035698
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
FULFILLEDLYF CARE AND COMMUNITY SERVICES LLC
Practice address
3220 County Road 10 Ste 107
Brooklyn Center, MN 55429-3075
Phone
(612) 346-3833
Fax
(415) 484-7068
NPI assigned
Jun 22, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Authorized official

Name
Brice Constantin Nganadere Sereckissy
Title
Ceo
Phone
(612) 346-3833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

3220 County Road 10 Ste 107
Brooklyn Center, MN 55429-3075

Mailing address

3220 County Road 10 Ste 107
Brooklyn Center, MN 55429-3075
Phone (612) 346-3833

National Provider Directory

National Provider Directory

Locations

3220 County Road 10
Ste 107
Brooklyn Center, MN 55429

NPI Registry JSON

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

{
    "created_epoch": "1782086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782086400000",
    "number": "1932035698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 COUNTY ROAD 10 STE 107",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554293075",
            "telephone_number": "612-346-3833",
            "fax_number": "415-484-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 COUNTY ROAD 10 STE 107",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554293075",
            "telephone_number": "612-346-3833",
            "fax_number": "415-484-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULFILLEDLYF CARE AND COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-22",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A",
        "authorized_official_last_name": "NGANADERE SERECKISSY",
        "authorized_official_first_name": "BRICE",
        "authorized_official_middle_name": "CONSTANTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-346-3833"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.