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BRISTOL CARE INC. NPI 1649486697


NPI Information

NPI: 1649486697
Provider Name: BRISTOL CARE, INC.

Other Name: BRISTOL MANOR OF WILLARD

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 26D0962942

Address:
511 WATSON ST
WILLARD, MO
ZIP 65781
Phone: (417) 742-0090
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BRISTOL CARE, INC. is an assisted living facility in Willard, MO. The provider is 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. BRISTOL CARE, INC. NPI is 1649486697. The provider is registered as an organization entity type.
The provider Other Name Is Bristol Manor Of Willard.

The provider's business location address is:

511 WATSON ST
WILLARD, MO
ZIP 65781-314
Phone: (417) 742-0090
Fax: (417) 742-0090

The provider's authorized official is Shelley D Ebeling .
The authorized official title is Medicaid Billing Department and has the following contact phone number (660) 826-0200.

The CLIA number assigned to this NPI record is 26D0962942 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/15/2007 and was last updated on 10/3/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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