Provider Demographics
NPI:1902952229
Name:TAYLORS ENHANCED LIVING INC.
Entity Type:Organization
Organization Name:TAYLORS ENHANCED LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:DANIELS
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-520-5944
Mailing Address - Street 1:1655 E TUCKAHOE ST
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-1429
Mailing Address - Country:US
Mailing Address - Phone:804-520-5944
Mailing Address - Fax:804-520-8575
Practice Address - Street 1:1738 BERKELEY AVE
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2806
Practice Address - Country:US
Practice Address - Phone:804-520-5944
Practice Address - Fax:804-520-8575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-27
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA839261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility