Active NPI
Fulfilledlyf Care and Community Services LLC
- In Home Supportive Care Agency
- Brooklyn Center, MN
National Provider Identifier
1932035698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.