Healthcare Provider Details

I. General information

NPI: 1255547634
Provider Name (Legal Business Name): TRILOGY HEALTHCARE OF GLEN RIDGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6415 CALM RIVER WAY
LOUISVILLE KY
40299-3250
US

IV. Provider business mailing address

6415 CALM RIVER WAY
LOUISVILLE KY
40299-3250
US

V. Phone/Fax

Practice location:
  • Phone: 502-297-8590
  • Fax: 502-297-8766
Mailing address:
  • Phone: 502-297-8590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100729
License Number StateKY

VIII. Authorized Official

Name: CRISTINA PIETROWSKI
Title or Position: EVP & CLO
Credential:
Phone: 502-213-7572