Provider Demographics
NPI:1902663867
Name:TAELOR MADE HOUSING LLC
Entity type:Organization
Organization Name:TAELOR MADE HOUSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARSHAE
Authorized Official - Middle Name:
Authorized Official - Last Name:RHYMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-224-2949
Mailing Address - Street 1:1836 TORREY PINES CT
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-2883
Mailing Address - Country:US
Mailing Address - Phone:510-224-2949
Mailing Address - Fax:
Practice Address - Street 1:1836 TORREY PINES CT
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-2883
Practice Address - Country:US
Practice Address - Phone:510-224-2949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care