MEDICARE: TRINITY CONTINUING CARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	634010	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09964	OTHER	MI	BCBSM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235223405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY CONTINUING CARE SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 9184
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48333-9184
Country	:	US
Telephone Number	:	734-542-8300
Fax Number	:	734-542-8384

Provider Business Practice Location Address
First Line	:	10770 ELIZABETH LAKE RD
Second Line	:
City	:	WHITE LAKE
State	:	MI
Zip	:	48386-2136
Country	:	US
Telephone Number	:	248-618-4100
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT REIMBURSEMENT
Name	:	PAMELA SUE LATOVICK
Credential	:
Telephone Number	:	734-343-6628

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	01/28/2024

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