MEDICARE: TAILORED SENIOR SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1093661548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAILORED SENIOR SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	3006 SW 6TH PL
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-5778
Country	:	US
Telephone Number	:	239-888-0410
Fax Number	:

Provider Business Practice Location Address
First Line	:	3006 SW 6TH PL
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-5778
Country	:	US
Telephone Number	:	239-888-0410
Fax Number	:

Authorized Official
Title or Position	:	OWNER,ADMINISTRATOR
Name	:	MS. BOUCHRA GOODRICH
Credential	:
Telephone Number	:	239-888-0410

Provider Enumeration Date	:	03/07/2026
Last Update Date	:	03/07/2026

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