Healthcare Provider Details

I. General information

NPI: 1184418006
Provider Name (Legal Business Name): TAILORED TO YOU HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 ENCLAVE WAY
HUTTO TX
78634-5334
US

IV. Provider business mailing address

1110 ENCLAVE WAY
HUTTO TX
78634-5334
US

V. Phone/Fax

Practice location:
  • Phone: 512-587-7204
  • Fax:
Mailing address:
  • Phone: 512-587-7204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TRACY TAYLOR GREEN
Title or Position: OWNER
Credential:
Phone: 512-587-7204