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General NPI Number Information
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NPI Number | 1972295756
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Entity Type | Organization
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Legal Business Name | TRILOGY SL MANAGER, LLC
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 8100 GEDDES RD
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City | YPSILANTI
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State | MI
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Zip | 48198-9569
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Country | US
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Telephone | 734-484-4740
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Fax |
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Provider Business Mailing Address
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Address Line | 1921 CORPORATE DR STE 101
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City | SAN MARCOS
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State | TX
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Zip | 78666-6075
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Country | US
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Telephone | 830-624-1044
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Fax | 512-667-7770
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Authorized Official
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Title or Position | MEDICAID BILLER
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Name | KRISTY GRAPHMAN
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Credential |
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Telephone | 830-624-1044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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