Healthcare Provider Details

I. General information

NPI: 1093661548
Provider Name (Legal Business Name): TAILORED SENIOR SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3006 SW 6TH PL
CAPE CORAL FL
33914-5778
US

IV. Provider business mailing address

3006 SW 6TH PL
CAPE CORAL FL
33914-5778
US

V. Phone/Fax

Practice location:
  • Phone: 239-888-0410
  • Fax:
Mailing address:
  • Phone: 239-888-0410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. BOUCHRA GOODRICH
Title or Position: OWNER,ADMINISTRATOR
Credential:
Phone: 239-888-0410