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General NPI Number Information
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NPI Number | 1972049658
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Entity Type | Organization
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Legal Business Name | BRISTOL TERRACE MANAGEMENT, LLC
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 2733 MCCAMPBELL AVE
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City | NASHVILLE
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State | TN
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Zip | 37214-2913
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Country | US
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Telephone | 615-889-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N FRANKLIN ST SUITE 2570
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City | TAMPA
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State | FL
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Zip | 33602-5182
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Country | US
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Telephone | 813-280-2000
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PREM R. SHAH
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Credential | M.D.
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Telephone | 813-280-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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