Provider Demographics
NPI:1295179224
Name:D. TAYLOR ENTERPRISE LLC
Entity Type:Organization
Organization Name:D. TAYLOR ENTERPRISE LLC
Other - Org Name:FIRST HEALTH INITIATIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAWAYNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:804-551-4158
Mailing Address - Street 1:3009 STONE ARBOR LN
Mailing Address - Street 2:APT 638
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7584
Mailing Address - Country:US
Mailing Address - Phone:804-551-4158
Mailing Address - Fax:
Practice Address - Street 1:601 S FIGUEROA ST
Practice Address - Street 2:SUITE 4050
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-5704
Practice Address - Country:US
Practice Address - Phone:804-551-4158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-21
Last Update Date:2013-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty