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Bristol Care, Inc.

Organization Active NPI Assisted Living Facility · Centralia, MO

NPI 1689880239 · NPPES record last updated Oct 2, 2007

Key facts

NPI
1689880239
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
Legal business name
BRISTOL CARE, INC.
Practice address
610 N Jefferson St
Centralia, MO 65240-1178
Phone
(573) 682-5913
Fax
(573) 682-5913
NPI assigned
May 14, 2007
Organization subpart
No

Authorized official

Name
Shelley Deanne Ebeling
Title
Medicaid Billing Department
Phone
(660) 826-0200

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0982149Bristol Manor of Centralia
610 N Jefferson, Centralia, MO 65240		Certificate of waiverJan 16, 2027

National Provider Directory

Tax ID family
Bristol Care Inc (62 organizations share this tax ID)

Locations

610 N Jefferson St
Centralia, MO 65240
Phone (573) 682-5913

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Yes

Addresses

Primary practice location

610 N Jefferson St
Centralia, MO 65240-1178

Mailing address

201 W 3Rd St
Sedalia, MO 65301-4352
Phone (660) 826-0200

Other names

  • Bristol Manor of Centralia Other name

Other providers in Centralia, MO

All providers in Centralia, MO · Assisted Living Facility in Missouri

Sources for this page

Verify at the official NPI Registry.