Healthcare Provider Details

I. General information

NPI: 1235659749
Provider Name (Legal Business Name): TAILORED SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6610 TRIBUTARY ST STE 300
BALTIMORE MD
21224-6514
US

IV. Provider business mailing address

6610 TRIBUTARY ST STE 300
BALTIMORE MD
21224-6514
US

V. Phone/Fax

Practice location:
  • Phone: 410-878-0690
  • Fax:
Mailing address:
  • Phone: 410-878-0690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateMD

VIII. Authorized Official

Name: MR. JAMAAL TAYLOR
Title or Position: PROGRAM DIRECTOR
Credential: MSW
Phone: 410-878-0690