Healthcare Provider Details

I. General information

NPI: 1699587972
Provider Name (Legal Business Name): TAYLORED CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 PALMETTO AVE
BEDFORD OH
44146-3225
US

IV. Provider business mailing address

149 PALMETTO AVE
BEDFORD OH
44146-3225
US

V. Phone/Fax

Practice location:
  • Phone: 216-280-6049
  • Fax:
Mailing address:
  • Phone: 216-280-6049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: EBONY DANIELLE TAYLOR
Title or Position: OWNER
Credential:
Phone: 218-280-6049