BRASK HAVEN INC
NPI 1780765487
Assisted Living Facility in North Branch, MN

NPI Status: Active since October 18, 2006

Contact Information

31274 JULLIARD ST NE
NORTH BRANCH, MN
ZIP 55056
Phone: (651) 674-7433
Fax: (651) 237-0563

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 24D1027732
  • CLIA Cert. Type: Other
  • CLIA Exp. Date: 07-07-2026

About BRASK HAVEN INC

This page provides the complete NPI Profile along with additional information for Brask Haven Inc, a provider established in North Branch, Minnesota operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1780765487 assigned on October 2006. The practitioner's primary taxonomy code is 310400000X with license number 330813 (MN). The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Ettafa Boka (Co-owner)

NPI
1780765487
Provider Name
BRASK HAVEN INC
Entity Type
Organization
Location Address
31274 JULLIARD ST NE NORTH BRANCH, MN 55056
Location Phone
(651) 674-7433
Location Fax
(651) 237-0563
Mailing Address
31274 JULLIARD ST NE NORTH BRANCH, MN 55056
Mailing Phone
(651) 674-7433
Mailing Fax
(651) 237-0563
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-18-2006
Last Update Date
05-06-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
330813
License State
MN
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ETTAFA BOKA

Authorized Official Title
CO-OWNER
Authorized Official Phone
(651) 448-9940

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
216303900OTHER (01)MNMHCP ID

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D1027732
Facility Type
Other
Certificate Effective Date
July 08, 2024
Certificate Expiration Date
July 07, 2026
Laboratory Director
ETTAFA L. BOKA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Brask Haven Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1780765487, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
0
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
6
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
4
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 7 → 14 → 5 5 → 10 → 1 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 6 + 0 + 1 + 4 + 6 + 1 + 0 + 4 + 1 + 6 + 24 = 63

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1780765487.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780765487, enumerated as an "organization" on October 18, 2006.

The provider is located at 31274 JULLIARD ST NE NORTH BRANCH, MN 55056 and the phone number is (651) 674-7433.

Assisted Living Facility with taxonomy code 310400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.