Bristol Village Management LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BRISTOL VILLAGE MANAGEMENT LLC

Practice address

1358 Manchester Dr NE
Conyers, GA 30012-3881

Phone

(470) 207-7250

Fax

(470) 207-7249

NPI assigned

Apr 22, 2015

Last updated

Apr 22, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Matthew Stephen

Title

Administrator

Phone

(470) 207-7250

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1760879332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1358 MANCHESTER DR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123881",
            "telephone_number": "470-207-7250",
            "fax_number": "470-207-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1358 MANCHESTER DR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123881",
            "telephone_number": "470-207-7250",
            "fax_number": "470-207-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL VILLAGE MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "STEPHEN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "470-207-7250",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Conyers, GA
• Providers in Conyers, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.