Provider Demographics
NPI:1366443228
Name:TRINITY CONTINUING CARE SERVICES
Entity type:Organization
Organization Name:TRINITY CONTINUING CARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP REIMBURSEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:LATOVICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-343-6628
Mailing Address - Street 1:20555 VICTOR PKWY
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-7031
Mailing Address - Country:US
Mailing Address - Phone:734-343-6628
Mailing Address - Fax:
Practice Address - Street 1:15475 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3805
Practice Address - Country:US
Practice Address - Phone:734-542-6360
Practice Address - Fax:734-427-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI824220314000000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2083002Medicaid
0850073000-8OtherMESC
MI824220OtherMDCIS/BHS
MI824220OtherMDCIS/BHS
MI23-5120Medicare PIN