MEDICARE: TAITO INC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1790630598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAITO INC LLC

Provider Business Mailing Address
First Line	:	4152 MASSEY PRESERVE TRL
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-3379
Country	:	US
Telephone Number	:	630-822-5214
Fax Number	:

Provider Business Practice Location Address
First Line	:	4152 MASSEY PRESERVE TRL
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-3379
Country	:	US
Telephone Number	:	630-822-5214
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TOHEEB OLAOYE
Credential	:
Telephone Number	:	630-822-5214

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	06/11/2026

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Directions to “TAITO INC LLC ” Practice Location

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