Healthcare Provider Details

I. General information

NPI: 1972417624
Provider Name (Legal Business Name): TAYLOR LIVING COMMUNITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 RICHARD LN
RED OAK TX
75154-5046
US

IV. Provider business mailing address

103 RICHARD LN
RED OAK TX
75154-5046
US

V. Phone/Fax

Practice location:
  • Phone: 214-715-3883
  • Fax:
Mailing address:
  • Phone: 214-715-3883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: TANGELA TAYLOR
Title or Position: OWNER/OPERATOR
Credential:
Phone: 214-715-3883