Provider Demographics
NPI:1255164125
Name:TRIFECTA HEALTH CARE INSTITUTE
Entity type:Organization
Organization Name:TRIFECTA HEALTH CARE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-529-7925
Mailing Address - Street 1:2017 AILOR AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-5806
Mailing Address - Country:US
Mailing Address - Phone:978-729-8921
Mailing Address - Fax:
Practice Address - Street 1:2017 AILOR AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-5806
Practice Address - Country:US
Practice Address - Phone:978-729-8921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-24
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder