Provider Demographics
NPI:1770455628
Name:TREVI ENTERPRISES LLC
Entity type:Organization
Organization Name:TREVI ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NOONE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:816-962-9077
Mailing Address - Street 1:561 NW STATE ROUTE 131
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MO
Mailing Address - Zip Code:64040-9469
Mailing Address - Country:US
Mailing Address - Phone:816-962-9077
Mailing Address - Fax:
Practice Address - Street 1:561 NW STATE ROUTE 131
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MO
Practice Address - Zip Code:64040-9469
Practice Address - Country:US
Practice Address - Phone:816-962-9077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-20
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty