Organization
TITAN STREAMSIDE OPERATOR, LLC
Active
Other names
Streamside Assisted Living and Memory Care
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA WONG (CFO)
(310) 725-0120
Entity
Organization
Contact information
Practice address
1355 S EDGEWATER CIR, NAMPA, ID 83686-6085
(208) 442-0097
Mailing address
840 APOLLO ST STE 100, EL SEGUNDO, CA 90245-4641
(310) 725-0120
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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