Provider Demographics
NPI:1932496452
Name:BRISTOL HOME CARE-UTAH LLC
Entity Type:Organization
Organization Name:BRISTOL HOME CARE-UTAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-325-0146
Mailing Address - Street 1:206 N 2100 W
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84116-4740
Mailing Address - Country:US
Mailing Address - Phone:801-325-0146
Mailing Address - Fax:801-478-3533
Practice Address - Street 1:4460 HIGHLAND DR
Practice Address - Street 2:STE. 240
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-3543
Practice Address - Country:US
Practice Address - Phone:801-272-0277
Practice Address - Fax:801-272-1047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health