Provider Demographics
NPI:1891183372
Name:TRILOGY HEALTHCARE OF LIVINGSTON, LLC
Entity Type:Organization
Organization Name:TRILOGY HEALTHCARE OF LIVINGSTON, LLC
Other - Org Name:THE WILLOWS AT HOWELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PLEVYAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-213-1710
Mailing Address - Street 1:PO BOX 221648
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40252-1648
Mailing Address - Country:US
Mailing Address - Phone:502-412-5847
Mailing Address - Fax:
Practice Address - Street 1:1500 BYRON RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48855-6772
Practice Address - Country:US
Practice Address - Phone:517-552-9323
Practice Address - Fax:517-552-9324
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRILOGY FSC INVESTORS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-06
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility