Healthcare Provider Details

I. General information

NPI: 1508791104
Provider Name (Legal Business Name): TAYLORED CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 2ND AVE SW
BAUDETTE MN
56623-4500
US

IV. Provider business mailing address

PO BOX 12
BAUDETTE MN
56623-0012
US

V. Phone/Fax

Practice location:
  • Phone: 651-335-5985
  • Fax:
Mailing address:
  • Phone: 651-335-5985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY R TAYLOR
Title or Position: OWNER/DC
Credential:
Phone: 651-338-0889