MEDICARE: TITANIUM NEWCO OHIO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1376482273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TITANIUM NEWCO OHIO LLC

Provider Business Mailing Address
First Line	:	6545 MARKET AVE N
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-2430
Country	:	US
Telephone Number	:	317-614-5677
Fax Number	:

Provider Business Practice Location Address
First Line	:	6545 MARKET AVE N
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-2430
Country	:	US
Telephone Number	:	317-614-5677
Fax Number	:

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	RICHARD RINK
Credential	:	MD
Telephone Number	:	317-614-5677

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/26/2026

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Directions to “TITANIUM NEWCO OHIO LLC ” Practice Location

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