Healthcare Provider Details

I. General information

NPI: 1114562147
Provider Name (Legal Business Name): TAYLOR CARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 BERTHA WILSON RD
BLANCH NC
27212-9795
US

IV. Provider business mailing address

1188 BERTHA WILSON RD
BLANCH NC
27212-9795
US

V. Phone/Fax

Practice location:
  • Phone: 336-694-4207
  • Fax: 326-694-4207
Mailing address:
  • Phone: 336-694-4207
  • Fax: 326-694-4207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. BARBARA LEE TAYLOR
Title or Position: OWNER / SUPERVISOR
Credential: DPM
Phone: 336-694-3286