Provider Demographics
NPI:1164139721
Name:TRIFECTA HOME CARE LLC
Entity Type:Organization
Organization Name:TRIFECTA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAWINDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-904-6514
Mailing Address - Street 1:1042 W HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-1080
Mailing Address - Country:US
Mailing Address - Phone:484-904-6514
Mailing Address - Fax:484-860-3208
Practice Address - Street 1:1042 W HAMILTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18101-1080
Practice Address - Country:US
Practice Address - Phone:484-904-6514
Practice Address - Fax:484-860-3208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103896039-0001Medicaid