Provider Demographics
NPI:1164286159
Name:TRILOGY HEALTHCARE OF HUDSONVILLE, LLC
Entity Type:Organization
Organization Name:TRILOGY HEALTHCARE OF HUDSONVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP & CLO
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIETROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-412-5847
Mailing Address - Street 1:3145 SUNCHASE AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-7857
Mailing Address - Country:US
Mailing Address - Phone:616-229-4414
Mailing Address - Fax:616-229-4415
Practice Address - Street 1:3145 SUNCHASE AVE
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-7857
Practice Address - Country:US
Practice Address - Phone:616-229-4414
Practice Address - Fax:616-229-4415
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRILOGY HEALTHCARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility