BRISTOL LIFESTYLE RECOVERY – NPI #1376064147
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Health Care Provider Taxonomy Code for Residential Treatment Facility, Intellectual and/or Developmental Disabilities

BRISTOL LIFESTYLE RECOVERY is a residential treatment facility located in BRISTOL, VA. NPPES has assigned the NPI number 1376064147 to BRISTOL LIFESTYLE RECOVERY on July 03, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BRISTOL LIFESTYLE RECOVERY” is a dba name, the actual legal business name for this organization is FAIRVIEW HOUSING MANAGEMENT CORP. This provider is also associated with 2 additional names listed below. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 320600000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 3 years ago on Sep 19, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BRISTOL LIFESTYLE RECOVERY below.

NPI Profile for
FAIRVIEW HOUSING MANAGEMENT CORP

NPI Number
1376064147
Enumeration Date

(about 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
FAIRVIEW HOUSING MANAGEMENT CORP
Doing Business As (dba): BRISTOL LIFESTYLE RECOVERY
Other name(s)
All associated names:
Doing Business As (dba)
BRISTOL LIFESTYLE RECOVERY
Doing Business As (dba)
Mended Women Lifestyle Recovery
Primary location
261 NORTH ST
BRISTOL, VA 24201-3275
Phone: (276) 821-8030 Fax:
2 Other location(s):
100 E Millard Street
Johnson City, TN 37602-5746
Phone: (423) 845-5600
482 Bradley St SW
Abingdon, VA 24210-3008
Phone: (276) 451-3996
Mailing address
PO BOX 5746
JOHNSON CITY, TN 37602-5746
Phone: (423) 612-2995 Fax:
Organization Subpart
No
Authorized Official
ROBERT GARRETT
PRESIDENT
Phone: (423) 612-2995
Updated
Certification Date
Sep 19, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320600000X
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)
251S00000X
- Community/Behavioral Health
101YA0400X
- Counselor / Addiction (Substance Use Disorder)		 TN LI0000000004235

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.