Healthcare Provider Details

I. General information

NPI: 1811132350
Provider Name (Legal Business Name): TRILOGY HEALTHCARE OF JEFFERSON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2008
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 FERN VALLEY RD
LOUISVILLE KY
40219-1916
US

IV. Provider business mailing address

3625 FERN VALLEY RD
LOUISVILLE KY
40219-1916
US

V. Phone/Fax

Practice location:
  • Phone: 502-964-3381
  • Fax: 502-964-7414
Mailing address:
  • Phone: 502-964-3381
  • Fax: 502-964-7414

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 Number100196
License Number StateKY

VIII. Authorized Official

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