MEDICARE: TITUS SENIOR HOME HEALTH, INC.

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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1639478878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TITUS SENIOR HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	14621 TITUS ST
Second Line	:	STE 204
City	:	VAN NUYS
State	:	CA
Zip	:	91402-4905
Country	:	US
Telephone Number	:	818-988-8087
Fax Number	:	818-988-8013

Provider Business Practice Location Address
First Line	:	14621 TITUS ST
Second Line	:	STE 204
City	:	VAN NUYS
State	:	CA
Zip	:	91402-4905
Country	:	US
Telephone Number	:	818-988-8087
Fax Number	:	818-988-8013

Authorized Official
Title or Position	:	CEO
Name	:	NATALIE RODRIGUEZ
Credential	:
Telephone Number	:	818-988-8087

Provider Enumeration Date	:	03/25/2011
Last Update Date	:	10/23/2014

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