1295917706 NPI number — TRINITY CONTINUING CARE SERVICE

Table of content: (NPI 1295917706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295917706 NPI number — TRINITY CONTINUING CARE SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRINITY CONTINUING CARE SERVICE
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:
Provider Other Organization Name Type Code:
6
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:
1295917706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 530009
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIVONIA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48153-0009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-343-6628
Provider Business Mailing Address Fax Number:
312-957-2672

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20555 VICTOR PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVONIA
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48152-7031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-343-6628
Provider Business Practice Location Address Fax Number:
312-957-2672
Provider Enumeration Date:
11/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BOWENS
Authorized Official First Name:
MARCUS
Authorized Official Middle Name:
Authorized Official Title or Position:
TREASURER, CFO
Authorized Official Telephone Number:
770-283-4006

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 521945054 . This is a "TAX ID" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 930907047 . This is a "TAX ID" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 382719605 . This is a "TAX ID" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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