1457433310 NPI number — TRINITY CONTINUING CARE SERVICES

Table of content: (NPI 1457433310)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457433310 NPI number — TRINITY CONTINUING CARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRINITY CONTINUING CARE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ABBEY LIVING CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457433310
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9184
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGTON HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48333-9184
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-305-7919
Provider Business Mailing Address Fax Number:
248-305-7677

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12250 E 12 MILE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48093-3516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-751-6200
Provider Business Practice Location Address Fax Number:
586-751-2234
Provider Enumeration Date:
10/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
JACKIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
248-305-7688

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  504010 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com