Healthcare Provider Details

I. General information

NPI: 1790630598
Provider Name (Legal Business Name): TAITO INC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4152 MASSEY PRESERVE TRL
RALEIGH NC
27616-3379
US

IV. Provider business mailing address

4152 MASSEY PRESERVE TRL
RALEIGH NC
27616-3379
US

V. Phone/Fax

Practice location:
  • Phone: 630-822-5214
  • Fax:
Mailing address:
  • Phone: 630-822-5214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: TOHEEB OLAOYE
Title or Position: ADMINISTRATOR
Credential:
Phone: 630-822-5214