Healthcare Provider Details

I. General information

NPI: 1164040069
Provider Name (Legal Business Name): TAYLOR HEALTH ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 SMITHFIELD AVE
PAWTUCKET RI
02860-2576
US

IV. Provider business mailing address

460 SMITHFIELD AVE
PAWTUCKET RI
02860-2576
US

V. Phone/Fax

Practice location:
  • Phone: 401-305-0080
  • Fax: 866-655-0696
Mailing address:
  • Phone: 401-305-0080
  • Fax: 401-574-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TEMPERANCE TAYLOR
Title or Position: OWNER
Credential: NP
Phone: 401-305-0080