Healthcare Provider Details

I. General information

NPI: 1104628551
Provider Name (Legal Business Name): TAILORED CARE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5435 EMERSON WAY STE 130
INDIANAPOLIS IN
46226-1466
US

IV. Provider business mailing address

5435 EMERSON WAY STE 130
INDIANAPOLIS IN
46226-1466
US

V. Phone/Fax

Practice location:
  • Phone: 317-879-5268
  • Fax: 317-744-9556
Mailing address:
  • Phone: 317-879-5268
  • Fax: 317-744-9556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TAQUITA T TAYLOR
Title or Position: OWNER
Credential: NP
Phone: 317-879-5268