Provider Demographics
NPI:1174510952
Name:TRINITY CONTINUING CARE SERVICES
Entity Type:Organization
Organization Name:TRINITY CONTINUING CARE SERVICES
Other - Org Name:THE ALVERNO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOSIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-542-8366
Mailing Address - Street 1:17410 COLLEGE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-2369
Mailing Address - Country:US
Mailing Address - Phone:734-542-8300
Mailing Address - Fax:734-542-8383
Practice Address - Street 1:849 13TH AVE N
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-5168
Practice Address - Country:US
Practice Address - Phone:563-242-1521
Practice Address - Fax:563-243-3016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAN-192314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0800086Medicaid
IA165509Medicare Oscar/Certification