MEDICARE: TRILOGY HEALTHCARE OF CLINTON, 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
2	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851732051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRILOGY HEALTHCARE OF CLINTON, LLC

Provider Business Mailing Address
First Line	:	3500 COOLIDGE RD
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-6376
Country	:	US
Telephone Number	:	517-203-4042
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 COOLIDGE RD
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-6376
Country	:	US
Telephone Number	:	502-412-5847
Fax Number	:

Authorized Official
Title or Position	:	EVP & CLO
Name	:	CRISTINA PIETROWSKI
Credential	:
Telephone Number	:	502-213-7572

Provider Enumeration Date	:	07/16/2013
Last Update Date	:	09/25/2025

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