MRS. RUBY LEE VARNUM (NPI# 1538400072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538400072 |
| Entity Type | Individual |
| Full Name | MRS. RUBY LEE VARNUM |
| Practice Address |
12167 Nw Freeman Rd Bristol FL 32321 |
| Mailing Address |
12167 Nw Freeman Road Varnum's Rest Home Bristol FL 32321 |
| Practice Telephone | 8506435155 |
| Practice Fax Number | 8506433721 |
| Mailing Telephone | 8506435155 |
| Mailing Fax Number | 8506433721 |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2013-03-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL6026 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 679025900 | 05 | |
| FL | 140029100 | 05 |
| Street Address |
12167 NW FREEMAN RD |
| City | BRISTOL |
| State | FL |
| Zip Code | 32321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649739194 | Amberly Portero | Counselor | 10611 Florida Highway 20, Bristol, FL 32321 | 2019-03-14 |
| 1194281121 | Ash Bailey Smith | Social Worker | 10659 Nw Sr 20, Bristol, FL 32321 | 2019-02-14 |
| 1508295692 | Maggie Chavez | Counselor | 12422 Ne Revell Road, Bristol, FL 32321 | 2013-11-08 |
| 1437586609 | Queen Brown Haven Assisted Living Facility | Assisted Living Facility | 6906 Nw Torreya Park Road, Bristol, FL 32321 | 2013-10-03 |
| 1417233321 | April Dawn Landrum | Case Management | 13888 Nw Cr 12, Apalachee Center, Inc., Bristol, FL 32321 | 2011-10-25 |
| 1417191107 | Elizabeth Stephanie Hofrichter | Social Worker | 11033 Nw Sr 20, Bristol, FL 32321 | 2009-04-24 |
| 1275734881 | Efren L Baltazar | Obstetrics & Gynecology | 2571 Executive Center Circle East, Howard Building Division of Disability Determination, Tallahassee, FL 32321 | 2007-05-30 |
| 1336260322 | Laban Bontrager | Dentist | 12761 Ne Pea Ridge Rd, Bristol, FL 32321 | 2007-04-03 |
| 1225192404 | Liberty County School Board | Local Education Agency (LEA) | 12926 Nw Cr 12, Bristol, FL 32321 | 2006-12-21 |
| 1093886020 | Lynne Howell Wahlquist | Pharmacist | 11049 Nw State Rd 20, Bristol, FL 32321 | 2006-11-13 |
| Find all providers in zip 32321 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548704596 | English Meadows | Assisted Living Facility | 306 Lynfield Rd, Bristol, TN 37620-6135 | 2016-12-10 |
| 1437586609 | Queen Brown Haven Assisted Living Facility | Assisted Living Facility | 6906 Nw Torreya Park Road, Bristol, FL 32321 | 2013-10-03 |
| 1235207044 | Bristol Assisted Living, Lp | Assisted Living Facility | 180 Franklin St, Bristol, RI 02809-3352 | 2006-12-01 |
| 1174189617 | Ec Opco Bristol, LLC | Assisted Living Facility | 826 Meadow View Rd, Bristol, TN 37620-9535 | 2019-05-09 |
| 1881100022 | Mccleary Assisted Living Services LLC | Assisted Living Facility | 212 Summer St, Bristol, NH 03222-3208 | 2017-12-26 |
| 1346595964 | Broadmore Senior Living | Assisted Living Facility | 826 Meadow View Rd, Bristol, TN 37620-9535 | 2012-07-19 |
| 1922371103 | Blc Bristol-gc, LLC | Assisted Living Facility | 1 Liberty Pl, Bristol, VA 24201-2360 | 2012-02-17 |
| 1104030717 | Sun Dial Manor Inc | Assisted Living Facility | 410 2nd St S, Bristol, SD 57219-0337 | 2007-05-10 |
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| 1982205019 | Cantillo Love & Care LLC | Assisted Living Facility | 1045 W 23rd St, Hialeah, FL 33010-1922 | 2020-11-04 |
| 1194326728 | Bliss Life Residential Care | Assisted Living Facility | 402 Arthur Ave, Lehigh Acres, FL 33936-7412 | 2020-11-02 |
| 1811597404 | Huguette Mortimer Dupont | Assisted Living Facility | 1596 Sw Paar Dr, Port St Lucie, FL 34953-6159 | 2020-11-01 |
| 1750981841 | Senior Living Properties IIi, LLC | Assisted Living Facility | 3791 Old Canoe Creek Rd, Saint Cloud, FL 34769-6630 | 2020-10-28 |
| 1417556028 | 5081 Cambridge LLC | Assisted Living Facility | 5081 Nw Dunn Rd, Fort Pierce, FL 34981-4942 | 2020-10-23 |
| 1134728926 | Pacifica Lauderhill LLC | Assisted Living Facility | 5500 Nw 69th Ave, Lauderhill, FL 33319-7266 | 2020-10-22 |
| 1760081749 | Hsre-ahr Zephyrhills LLC | Assisted Living Facility | 38130 Pretty Pond Road, Zephyrhills, FL 33540 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.