Healthcare Provider Details

I. General information

NPI: 1912493149
Provider Name (Legal Business Name): TRILOGY HEALTHCARE OF JEFFERSON II, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2018
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 STONY BROOK DR
LOUISVILLE KY
40220-4016
US

IV. Provider business mailing address

2200 STONY BROOK DR
LOUISVILLE KY
40220-4014
US

V. Phone/Fax

Practice location:
  • Phone: 502-491-4692
  • Fax: 502-491-4693
Mailing address:
  • Phone: 502-491-4692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100645
License Number StateKY

VIII. Authorized Official

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