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General NPI Number Information
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NPI Number | 1003394693
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Entity Type | Organization
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Legal Business Name | CPLACE BRISTOL SNF, LLC
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Dates
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Enumeration Date | 08/06/2018
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 109 VILLAGE CIRCLE
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City | BRISTOL
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State | VA
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Zip | 24201
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Country | US
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Telephone | 727-239-4462
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Fax |
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Provider Business Mailing Address
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Address Line | 24641 US HIGHWAY 19 N
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City | CLEARWATER
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State | FL
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Zip | 33763-5007
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Country | US
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Telephone | 337-349-5061
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE GENERAL COUNSEL
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Name | VIRGINIA L HINES
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Credential | ESQ.
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Telephone | 337-349-5061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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