Titan Senquest

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

TITAN SENQUEST

Doing business as

Liberty Residence

Practice address

250 Smokerise Dr
Wadsworth, OH 44281-8210

Phone

(330) 336-3616

Fax

(330) 336-9173

NPI assigned

Jan 15, 2020

Organization subpart

No

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

Authorized official

Name

Bev Long

Title

Admissions

Phone

(330) 336-3616

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Liberty Residence Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1487294625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 SMOKERISE DR",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818210",
            "telephone_number": "330-336-3616",
            "fax_number": "330-336-9173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 SMOKERISE DR",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818210",
            "telephone_number": "330-336-3616",
            "fax_number": "330-336-9173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITAN SENQUEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "BEV",
        "authorized_official_title_or_position": "ADMISSIONS",
        "authorized_official_telephone_number": "330-336-3616"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "533374544",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://drive.google.com/drive/my-drive",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "250 Smokerise Dr",
            "city": "Wadsworth",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442818210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Liberty Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Wadsworth, OH
• Providers in Wadsworth, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.