Healthcare Provider Details

I. General information

NPI: 1497688170
Provider Name (Legal Business Name): TAYLORMADE ELITE HOMECARE LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25929 CYPRESSWOOD DR STE A
SPRING TX
77373-3329
US

IV. Provider business mailing address

5435 PINECLIFF GROVE CT
SPRING TX
77373-2451
US

V. Phone/Fax

Practice location:
  • Phone: 951-203-1409
  • Fax:
Mailing address:
  • Phone: 951-203-1409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: SHANNON HENDERSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 951-203-1409