Provider Demographics
NPI:1780338566
Name:TAYLOR FAMILY CARE 2 LLC
Entity type:Organization
Organization Name:TAYLOR FAMILY CARE 2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / SUPERVISOR IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESTELLA
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:SPANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-694-1878
Mailing Address - Street 1:1136 BERTHA WILSON RD
Mailing Address - Street 2:
Mailing Address - City:BLANCH
Mailing Address - State:NC
Mailing Address - Zip Code:27212-9795
Mailing Address - Country:US
Mailing Address - Phone:336-694-1878
Mailing Address - Fax:336-694-1878
Practice Address - Street 1:1136 BERTHA WILSON RD
Practice Address - Street 2:
Practice Address - City:BLANCH
Practice Address - State:NC
Practice Address - Zip Code:27212-9795
Practice Address - Country:US
Practice Address - Phone:336-694-1878
Practice Address - Fax:336-694-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC017058OtherFACILITY LICENSE NUMBER