Organization
BRISTOL PLACE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL R SCHNEIDER (EXECUTIVE DIRECTOR)
(612) 871-0805
Entity
Organization
Contact information
Practice address
412 RIDGEWOOD AVE S, MINNEAPOLIS, MN 55403-3585
(612) 871-0805
(612) 871-0455
Mailing address
412 RIDGEWOOD AVE S, MINNEAPOLIS, MN 55403-3585
(612) 871-0805
(612) 871-0455
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
8014812RS
MN
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
8025061RS
MN
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
803962WS
MN
Other
Enumeration date
10/02/2006
Last updated
08/22/2020
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