Provider Demographics
NPI:1528774056
Name:TITANS HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:TITANS HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAO
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:148-020-7890
Mailing Address - Street 1:11615 W HACKBARTH DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGTOWN
Mailing Address - State:AZ
Mailing Address - Zip Code:85363-1746
Mailing Address - Country:US
Mailing Address - Phone:480-207-8904
Mailing Address - Fax:
Practice Address - Street 1:1802 W DESERT SEASONS DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6390
Practice Address - Country:US
Practice Address - Phone:480-207-8904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities