MEDICARE: STANDARD OF CARE 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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1932739802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANDARD OF CARE LLC

Provider Business Mailing Address
First Line	:	721 US HIGHWAY 1 STE 114-115
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4512
Country	:	US
Telephone Number	:	561-247-7952
Fax Number	:	800-863-1777

Provider Business Practice Location Address
First Line	:	721 US HIGHWAY 1 STE 114-115
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4512
Country	:	US
Telephone Number	:	561-247-7952
Fax Number	:	800-863-1777

Authorized Official
Title or Position	:	CEO
Name	:	DR. TAYLOR EVERETT GAINES
Credential	:	PHARMD
Telephone Number	:	561-352-1587

Provider Enumeration Date	:	01/20/2020
Last Update Date	:	01/13/2023

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Directions to “STANDARD OF CARE LLC ” Practice Location

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