MEDICARE: TAYLOR MADE CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	251B00000X	Case Management Agency
3	3104A0625X	Assisted Living Facility (Mental Illness)
4	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1396601738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAYLOR MADE CARE LLC

Provider Business Mailing Address
First Line	:	1910 COUNTY HOSPITAL RD
Second Line	:	MAIN HOUSE
City	:	NASHVILLE
State	:	TN
Zip	:	37218-2606
Country	:	US
Telephone Number	:	914-619-0155
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 COUNTY HOSPITAL RD
Second Line	:	MAIN HOUSE
City	:	NASHVILLE
State	:	TN
Zip	:	37218-2606
Country	:	US
Telephone Number	:	914-619-0155
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MR. JESSE HENRY
Credential	:
Telephone Number	:	914-619-0155

Provider Enumeration Date	:	12/30/2025
Last Update Date	:	12/30/2025

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