Healthcare Provider Details

I. General information

NPI: 1447164363
Provider Name (Legal Business Name): TITUS RECOVERY GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 E 7TH AVE
BRISTOW OK
74010-2605
US

IV. Provider business mailing address

PO BOX 129
BRISTOW OK
74010-0129
US

V. Phone/Fax

Practice location:
  • Phone: 918-818-1264
  • Fax:
Mailing address:
  • Phone: 918-818-1264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: TIMOTHY AARON KEETON
Title or Position: CEO/FOUNDER
Credential: CMII, PRSS
Phone: 918-818-1264