Provider Demographics
NPI:1992892525
Name:TRINITY CONTINUING CARE SERVICES
Entity type:Organization
Organization Name:TRINITY CONTINUING CARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KASTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-343-6644
Mailing Address - Street 1:PO BOX 9184
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-9184
Mailing Address - Country:US
Mailing Address - Phone:734-542-8300
Mailing Address - Fax:734-542-8384
Practice Address - Street 1:1050 4 MILE RD NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49544-1505
Practice Address - Country:US
Practice Address - Phone:616-784-0646
Practice Address - Fax:616-784-4552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI414350314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI60-2649184Medicaid
MI09679OtherBCBSM
MI60-2649184Medicaid