Healthcare Provider Details

I. General information

NPI: 1992892525
Provider Name (Legal Business Name): TRINITY CONTINUING CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 4 MILE RD NW
GRAND RAPIDS MI
49544-1505
US

IV. Provider business mailing address

PO BOX 9184
FARMINGTON HILLS MI
48333-9184
US

V. Phone/Fax

Practice location:
  • Phone: 616-784-0646
  • Fax: 616-784-4552
Mailing address:
  • Phone: 734-542-8300
  • Fax: 734-542-8384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number414350
License Number StateMI

VIII. Authorized Official

Name: STEVEN M. KASTNER
Title or Position: CEO
Credential:
Phone: 734-343-6644