Provider Demographics
NPI:1235207044
Name:BRISTOL ASSISTED LIVING, LP
Entity Type:Organization
Organization Name:BRISTOL ASSISTED LIVING, LP
Other - Org Name:FRANKLIN COURT ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-253-3679
Mailing Address - Street 1:180 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-3352
Mailing Address - Country:US
Mailing Address - Phone:401-253-3679
Mailing Address - Fax:401-253-5855
Practice Address - Street 1:180 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-3352
Practice Address - Country:US
Practice Address - Phone:401-253-3679
Practice Address - Fax:401-253-5855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIALR01409310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIBA40441Medicaid