Healthcare Provider Details

I. General information

NPI: 1891747036
Provider Name (Legal Business Name): TRILOGY HEALTHCARE OF PUTNAM II, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/03/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 OTTAWA GLANDORF RD
OTTAWA OH
45875-9426
US

IV. Provider business mailing address

575 OTTAWA GLANDORF RD
OTTAWA OH
45875-9426
US

V. Phone/Fax

Practice location:
  • Phone: 419-538-6529
  • Fax: 419-538-6520
Mailing address:
  • Phone: 419-538-6529
  • Fax: 419-538-6520

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 Number
License Number State

VIII. Authorized Official

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