Organization
BRISTOL PLC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT EDWARD PETRAS JR. (CO-OWNER/COO)
(260) 797-9482
Entity
Organization
Contact information
Practice address
3479 54TH AVE N, ST PETERSBURG, FL 33714-2426
(727) 520-8888
Mailing address
3630 ILLINOIS RD, FORT WAYNE, IN 46804-2062
(260) 797-9482
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/20/2017
Last updated
11/20/2017
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