Provider Demographics
NPI:1386849909
Name:TAYLORED CARE INC
Entity Type:Organization
Organization Name:TAYLORED CARE INC
Other - Org Name:LUBBOCK ADULT DAY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:806-796-2273
Mailing Address - Street 1:3306 83RD ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2809
Mailing Address - Country:US
Mailing Address - Phone:806-796-2273
Mailing Address - Fax:806-792-4181
Practice Address - Street 1:3306 83RD ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2809
Practice Address - Country:US
Practice Address - Phone:806-796-2273
Practice Address - Fax:806-792-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001001349Medicaid