Healthcare Provider Details

I. General information

NPI: 1578254595
Provider Name (Legal Business Name): TAILORED2CARE HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 10/19/2024
Certification Date: 10/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 DUSTY LN
MACON GA
31211-7502
US

IV. Provider business mailing address

227 DUSTY LN
MACON GA
31211-7502
US

V. Phone/Fax

Practice location:
  • Phone: 478-718-5538
  • Fax:
Mailing address:
  • Phone: 478-718-5538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ALEXIS THOMPSON
Title or Position: OWNER
Credential:
Phone: 478-718-5538