Provider Demographics
NPI:1700760790
Name:TAYLOR PEACEFUL LIVING INC
Entity type:Organization
Organization Name:TAYLOR PEACEFUL LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-485-6844
Mailing Address - Street 1:1319 N TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2422
Mailing Address - Country:US
Mailing Address - Phone:813-485-6844
Mailing Address - Fax:
Practice Address - Street 1:1319 N TAYLOR RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-2422
Practice Address - Country:US
Practice Address - Phone:813-485-6844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-02
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health