Trinity Living Center, LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

330102 Issued in PA

Legal business name

TRINITY LIVING CENTER, LP

Practice address

400 Hillcrest Ave
Grove City, PA 16127-1708

Phone

(724) 431-0770

Fax

(724) 431-0764

NPI assigned

Aug 30, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steven D Tack, NHA

Title

Ceo

Phone

(724) 431-0770

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1760475289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HILLCREST AVE",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161271708",
            "telephone_number": "724-431-0770",
            "fax_number": "724-431-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HILLCREST AVE",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161271708",
            "telephone_number": "724-431-0770",
            "fax_number": "724-431-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY LIVING CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "TACK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "724-431-0770",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "330102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HP",
            "identifier": "1524764",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHIC, CORP",
            "identifier": "4458820001",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC",
            "identifier": "1375",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "320495",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4809046",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018464740001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "119691",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Grove City, PA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.