Provider Demographics
NPI:1114083540
Name:BRIH DESIGN LLC
Entity Type:Organization
Organization Name:BRIH DESIGN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMARANVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-522-3945
Mailing Address - Street 1:4535 WASHBURN AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55412-1055
Mailing Address - Country:US
Mailing Address - Phone:612-522-3945
Mailing Address - Fax:612-522-5124
Practice Address - Street 1:4535 WASHBURN AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55412-1055
Practice Address - Country:US
Practice Address - Phone:612-522-3945
Practice Address - Fax:612-522-5124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN60D83OSOtherBLUECROSSBLUESHEILD GRP#