Healthcare Provider Details

I. General information

NPI: 1124073895
Provider Name (Legal Business Name): TRILOGY HEALTHCARE OF ALLEN II, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 11/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

883 W SPRING ST
LIMA OH
45805-3228
US

IV. Provider business mailing address

883 W SPRING ST
LIMA OH
45805-3228
US

V. Phone/Fax

Practice location:
  • Phone: 419-227-3661
  • Fax:
Mailing address:
  • Phone: 419-227-3661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL J. PLEVYAK
Title or Position: SENIOR VICE PRESIDENT FINANCE
Credential:
Phone: 502-213-1710