Titan Buhl Operator

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

TITAN BUHL OPERATOR

Practice address

1043 Burley Ave
Buhl, ID 83316-1811

Phone

(208) 543-2800

NPI assigned

Jul 22, 2024

Last updated

Jul 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebecca Wong

Title

Cfo

Phone

(310) 725-0120

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1841028933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 APOLLO ST STE 100",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 BURLEY AVE",
            "city": "BUHL",
            "state": "ID",
            "postal_code": "833161811",
            "telephone_number": "208-543-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1083 Burley Ave",
            "address_purpose": "LOCATION",
            "city": "Buhl",
            "state": "ID",
            "postal_code": "833161811",
            "country_code": "US",
            "telephone_number": "208-543-9384",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1063 Burley Ave",
            "address_purpose": "LOCATION",
            "city": "Buhl",
            "state": "ID",
            "postal_code": "833161811",
            "country_code": "US",
            "telephone_number": "208-543-5161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TITAN BUHL OPERATOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CFO",
        "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": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.