Healthcare Provider Details

I. General information

NPI: 1770405904
Provider Name (Legal Business Name): TAYLOR GROWTH & WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 FITZHUGH AVE STE 306
RICHMOND VA
23230-3531
US

IV. Provider business mailing address

2900 EAGLE TRACE TER
RICHMOND VA
23223-1188
US

V. Phone/Fax

Practice location:
  • Phone: 804-398-2101
  • Fax:
Mailing address:
  • Phone: 804-398-2101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TANJA TAYLOR
Title or Position: CO-FOUNDER
Credential: BS
Phone: 804-398-2101