Healthcare Provider Details

I. General information

NPI: 1427980879
Provider Name (Legal Business Name): AA ACCESS CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 32ND AVE S STE 102
FARGO ND
58103-5911
US

IV. Provider business mailing address

1531 32ND AVE S STE 102
FARGO ND
58103-5911
US

V. Phone/Fax

Practice location:
  • Phone: 701-516-1929
  • Fax:
Mailing address:
  • Phone: 701-516-1929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BRICE CONSTANTIN NGANADERE SERECKISSY
Title or Position: OWNER/CEO
Credential:
Phone: 612-346-3833