Healthcare Provider Details

I. General information

NPI: 1871236745
Provider Name (Legal Business Name): BRISTOL ADULT DAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1278 VETERANS HIGHWAY SUITE E-2
BRISTOL PA
19007
US

IV. Provider business mailing address

1278 VETERANS HIGHWAY SUITE E-2
BRISTOL PA
19007
US

V. Phone/Fax

Practice location:
  • Phone: 267-774-7677
  • Fax: 267-263-3442
Mailing address:
  • Phone: 267-474-4892
  • Fax: 267-263-3442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HIMANSHU I PATEL
Title or Position: DIRECTOR
Credential:
Phone: 267-632-8585