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

Q: What is Brask Haven Inc's NPI number?

The NPI number for Brask Haven Inc is 1780765487. It was assigned to this organization in the NPPES registry on October 18, 2006.

Q: What is Brask Haven Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Q: When was this NPI record last updated?

The NPPES record for Brask Haven Inc was last updated on May 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 18, 2006CLIA 24D1027732 · Waiver

31274 JULLIARD ST NE, NORTH BRANCH, MN 55056(651) 674-7433(651) 237-0563 Get Directions Write a Review

NPPES record last updated: May 6, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 6, 2024, Aug 22, 2020 (2 updates tracked since 2020).

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About Brask Haven Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRASK HAVEN INC (NPI 1780765487) is a healthcare organization registered as an assisted living facility in North Branch, Minnesota and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through July 7, 2028 and lists Ettafa Boka, Co-owner, as its authorized official.

NPPES Registry Identity

NPI1780765487

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameBRASK HAVEN INC

Location Address31274 JULLIARD ST NENorth Branch, MN 55056-6546

Mailing Address31274 Julliard St NeNorth Branch, MN 55056-6546 · (651) 674-7433 · Fax (651) 237-0563

Phone(651) 674-7433

Fax(651) 237-0563

Organization SubpartNo

Authorized OfficialEttafa BokaCo-owner · (651) 448-9940

Enumeration DateOctober 18, 2006

Last NPPES UpdateMay 6, 20242 updates tracked since enumeration

NPPES CertifiedMay 6, 2024

✔ NPI 1780765487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in MN · 330813

Definition

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.

31274 JULLIARD ST NE, North Branch, MN 55056

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Other Identifiers 1

Other216303900MN · Mhcp Id

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D1027732

Brask Haven Inc · North Branch, MN

Active · expires Jul 7, 2028

CLIA Number24D1027732

Laboratory TypeOther

Certificate Effective DateJuly 8, 2026

Certificate Expiration DateJuly 7, 2028

Laboratory DirectorEttafa L. Boka

Laboratory Phone(651) 674-7433

Laboratory LocationBrask Haven Inc31274 Julliard St NE, North Branch, MN 55056

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brask Haven Inc's NPI number?

The NPI number for Brask Haven Inc is 1780765487. It was assigned to this organization in the NPPES registry on October 18, 2006.

Where is Brask Haven Inc located?

Brask Haven Inc is located at 31274 Julliard St NE, North Branch, MN 55056. The listed phone number is (651) 674-7433.

What is Brask Haven Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Brask Haven Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1027732) is associated with this NPI, valid through July 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Brask Haven Inc was last updated on May 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.