Provider Demographics
NPI:1417219395
Name:TRINITY CONTINUING CARE SERVICES INDIANA INC
Entity Type:Organization
Organization Name:TRINITY CONTINUING CARE SERVICES INDIANA INC
Other - Org Name:ST. PAUL'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLLHIMER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:574-284-9060
Mailing Address - Street 1:3602 S IRONWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614
Mailing Address - Country:US
Mailing Address - Phone:574-299-2250
Mailing Address - Fax:574-299-2363
Practice Address - Street 1:3602 S IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-2453
Practice Address - Country:US
Practice Address - Phone:574-299-2250
Practice Address - Fax:574-299-2363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300030439Medicaid
IN100266590AMedicaid