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General NPI Number Information
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NPI Number | 1528774056
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Entity Type | Organization
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Legal Business Name | TITANS HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 01/27/2023
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 1802 W DESERT SEASONS DR
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-6390
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Country | US
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Telephone | 480-207-8904
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Fax |
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Provider Business Mailing Address
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Address Line | 11615 W HACKBARTH DR
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City | YOUNGTOWN
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State | AZ
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Zip | 85363-1746
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Country | US
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Telephone | 480-207-8904
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Fax |
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | SAO BRIMA
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Credential |
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Telephone | 148-020-7890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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