Organization
TITAN WILLOW OPERATOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN KASEFF (MANAGER)
(310) 725-0120
Entity
Organization
Contact information
Practice address
THE WILLOWS, 898 S MERIDIAN STREET, BLACKFOOT, ID 83221
(208) 678-4411
Mailing address
THE WILLOWS, 898 S MERIDIAN STREET, BLACKFOOT, ID 83221
(208) 678-4411
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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