Provider Demographics
NPI:1285727701
Name:BRISTOL PLACE HOME HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:BRISTOL PLACE HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-871-0805
Mailing Address - Street 1:412 RIDGEWOOD AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-3585
Mailing Address - Country:US
Mailing Address - Phone:612-871-0805
Mailing Address - Fax:612-813-0158
Practice Address - Street 1:412 RIDGEWOOD AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3585
Practice Address - Country:US
Practice Address - Phone:612-871-0805
Practice Address - Fax:612-813-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN330943251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN92618OtherHEALTH PARTNERS
MN4880060OtherMEDICA
MN111835OtherUCARE
MN4111BROtherBLUE CROSS BLUE SHIELD
WI=========014OtherBCBS OF WISCONSIN
MN248004Medicare ID - Type UnspecifiedMEDICARE