Titan Streamside Operator, LLC
Assisted Living Facility in Nampa, ID. Organization (NPI-2).
NPI number1295563385
StatusActive
Last updated in NPPESJul 22, 2024
Details
- NPI
- 1295563385
- Entity type
- Organization (NPI-2)
- Legal business name
- Titan Streamside Operator, LLC
- Organization subpart
- No
- Enumeration date
- Jul 22, 2024
- Certification date
- Jul 22, 2024
- Last updated
- Jul 22, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
| 311500000X | Alzheimer Center (Dementia Center) | – | – |
Other names
- Streamside Assisted Living And Memory Care (Doing Business As)
Practice location
1355 S Edgewater CirNampa, ID 83686-6085
Phone 208-442-0097
Mailing address
840 Apollo St Ste 100El Segundo, CA 90245-4641
Phone 310-725-0120
Authorized official
Rebecca Wong
Cfo
3107250120
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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