Provider Demographics
NPI:1407146491
Name:TITUS BRIDGE HOME HEALTH
Entity Type:Organization
Organization Name:TITUS BRIDGE HOME HEALTH
Other - Org Name:TITUS BRIDGE APARTMENTS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:785-331-8782
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:VALLEY FALLS
Mailing Address - State:KS
Mailing Address - Zip Code:66088-0035
Mailing Address - Country:US
Mailing Address - Phone:785-331-8782
Mailing Address - Fax:
Practice Address - Street 1:133 W JACKSON AVE
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:KS
Practice Address - Zip Code:66413-1137
Practice Address - Country:US
Practice Address - Phone:785-331-8782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health