Organization
BRISTOL CCH GROUP, LLC
Active
Parent organization
ATHENA HEALTH CARE ASSOCIATES
Other names
Countryside Manor of Bristol
Organization subpart
Yes
Provider details
NPI number
Legal business name
ATHENA HEALTH CARE ASSOCIATES
Authorized official
MICHAEL MOSIER (CFO)
(860) 751-3900
Entity
Organization
Contact information
Practice address
1660 STAFFORD AVE, BRISTOL, CT 06010-2571
(860) 583-8483
(860) 585-7913
Mailing address
1660 STAFFORD AVE, BRISTOL, CT 06010-2571
(860) 583-8483
(860) 585-7913
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2285C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000021303
—
CT
Enumeration date
04/11/2013
Last updated
04/11/2013
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