Provider Demographics
NPI:1801559943
Name:TRILOGY HEALTHCARE OF PUTNAM, LLC
Entity type:Organization
Organization Name:TRILOGY HEALTHCARE OF PUTNAM, 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:502-213-7572
Mailing Address - Street 1:755 OTTAWA ST
Mailing Address - Street 2:
Mailing Address - City:KALIDA
Mailing Address - State:OH
Mailing Address - Zip Code:45853-2096
Mailing Address - Country:US
Mailing Address - Phone:419-532-2961
Mailing Address - Fax:
Practice Address - Street 1:755 OTTAWA ST
Practice Address - Street 2:
Practice Address - City:KALIDA
Practice Address - State:OH
Practice Address - Zip Code:45853-0388
Practice Address - Country:US
Practice Address - Phone:419-532-2961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRILOGY INVESTORS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-15
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2811372Medicaid