Healthcare Provider Details

I. General information

NPI: 1528884269
Provider Name (Legal Business Name): TILT HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 LORNA RD STE 100
HOOVER AL
35216-5450
US

IV. Provider business mailing address

3100 LORNA RD STE 100
HOOVER AL
35216-5450
US

V. Phone/Fax

Practice location:
  • Phone: 205-573-6090
  • Fax:
Mailing address:
  • Phone: 205-573-6090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRENQUETTA CARR
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 205-382-2133