MEDICARE: TRINITY CONTINUING CARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1750714002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY CONTINUING CARE SERVICES

Provider Business Mailing Address
First Line	:	4170 24TH AVE
Second Line	:
City	:	FORT GRATIOT
State	:	MI
Zip	:	48059-3886
Country	:	US
Telephone Number	:	810-989-7440
Fax Number	:	810-989-7449

Provider Business Practice Location Address
First Line	:	4170 24TH AVE
Second Line	:
City	:	FORT GRATIOT
State	:	MI
Zip	:	48059-3886
Country	:	US
Telephone Number	:	810-989-7440
Fax Number	:	810-989-7449

Authorized Official
Title or Position	:	VP REIMBURSEMENT
Name	:	PAM LATOVICK
Credential	:
Telephone Number	:	734-343-6628

Provider Enumeration Date	:	08/09/2013
Last Update Date	:	11/06/2023

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