Provider Demographics
NPI:1306190699
Name:TAYLOR-MADE HOME CARE, LLC
Entity type:Organization
Organization Name:TAYLOR-MADE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TATRINA
Authorized Official - Middle Name:MARNITA
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:BSHA
Authorized Official - Phone:313-989-7624
Mailing Address - Street 1:PO BOX 35056
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-0056
Mailing Address - Country:US
Mailing Address - Phone:888-507-2003
Mailing Address - Fax:888-507-2003
Practice Address - Street 1:16745 MURRAY HILL ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3639
Practice Address - Country:US
Practice Address - Phone:313-989-7624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care