=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447164363
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TITUS RECOVERY GROUP INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2026
-----------------------------------------------------
Last Update Date | 09/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 619 E 7TH AVE
-----------------------------------------------------
City | BRISTOW
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74010-2605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-818-1264
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 129
-----------------------------------------------------
City | BRISTOW
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74010-0129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-818-1264
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/FOUNDER
-----------------------------------------------------
Name | TIMOTHY AARON KEETON
-----------------------------------------------------
Credential | CMII, PRSS
-----------------------------------------------------
Telephone | 918-818-1264
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QR0405X
-----------------------------------------------------
Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------