MEDICARE: TRILOGY HEALTHCARE OF SHELBY FARMS, LLC

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1760125421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRILOGY HEALTHCARE OF SHELBY FARMS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 221648
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40252-1648
Country	:	US
Telephone Number	:	502-412-5847
Fax Number	:	502-412-0407

Provider Business Practice Location Address
First Line	:	100 WILLIAMSBURG DR
Second Line	:
City	:	SHELBYVILLE
State	:	KY
Zip	:	40065-8549
Country	:	US
Telephone Number	:	502-257-9485
Fax Number	:	502-257-9486

Authorized Official
Title or Position	:	CHIEF LEGAL OFFICER
Name	:	CRISTINA PIETROWSKI
Credential	:
Telephone Number	:	502-412-5847

Provider Enumeration Date	:	04/19/2022
Last Update Date	:	07/16/2025

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