MEDICARE: TAYLORMADE ELITE HOMECARE LLC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1497688170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAYLORMADE ELITE HOMECARE LLC.

Provider Business Mailing Address
First Line	:	5435 PINECLIFF GROVE CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-2451
Country	:	US
Telephone Number	:	951-203-1409
Fax Number	:

Provider Business Practice Location Address
First Line	:	25929 CYPRESSWOOD DR STE A
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-3329
Country	:	US
Telephone Number	:	951-203-1409
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SHANNON HENDERSON
Credential	:
Telephone Number	:	951-203-1409

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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