Provider Demographics
NPI:1407644750
Name:TITAN WELLNESS GROUP LLC
Entity type:Organization
Organization Name:TITAN WELLNESS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATERINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAULFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-447-8103
Mailing Address - Street 1:265 E WARM SPRINGS RD STE 104-106
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4227
Mailing Address - Country:US
Mailing Address - Phone:617-447-8103
Mailing Address - Fax:772-873-9997
Practice Address - Street 1:265 E WARM SPRINGS RD STE 104-106
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4227
Practice Address - Country:US
Practice Address - Phone:617-447-8103
Practice Address - Fax:772-873-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility