Titan Willow Operator LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

TITAN WILLOW OPERATOR LLC

Practice address

The Willows
898 S Meridian Street
Blackfoot, ID 83221

Phone

(208) 678-4411

NPI assigned

May 30, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kevin Kaseff

Title

Manager

Phone

(310) 725-0120

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1467145151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THE WILLOWS",
            "address_2": "898 S MERIDIAN STREET",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "83221",
            "telephone_number": "208-678-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE WILLOWS",
            "address_2": "898 S MERIDIAN STREET",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "83221",
            "telephone_number": "208-678-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITAN WILLOW OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "KASEFF",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-725-0120"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Nichole Thomas, PA-C
• Genevieve Lafaye Thomas, LCSW
• Tia Thomas, LCSW
• Thrifty Payless Inc
• Titan Willow Operator LLC
• Kathleen S Tomazin, LCPC
• Paul Francis Tomechko, PHARMACIST
• Peggy Toro, MD
• Townsquare Dental of Blackfoot PLLC
• Ashley Trafford, LPC

• Assisted Living Facility in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Assisted Living Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.