| Name: | Taylor Health Enterprises, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 21 Aug 2019 (5 years ago) |
| Identification Number: | 001699196 |
| ZIP code: | 02914 |
| County: | Providence County |
| Principal Address: | 400 WARREN AVENUE SUITE 2L-A, EAST PROVIDENCE, RI, 02914, USA |
| Mailing Address: | 400 WARREN AVE SUITE 2L-A, EAST PROVIDENCE, RI, 02914, US |
| Purpose: | PRIMARY CARE CLINIC, WEIGHT LOSS PROGRAM, ALL AGES |
| NAICS: | 621399 - Offices of All Other Miscellaneous Health Practitioners |
| Fictitious names: |
Discreet Testing Solution (trading name, 2022-02-16 - ) Lotus Noire Health, LLC (trading name, 2020-02-09 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164040069 | 2020-07-08 | 2024-07-22 | 400 WARREN AVE STE 2L-A, EAST PROVIDENCE, RI, 029143826, US | 460 SMITHFIELD AVE, PAWTUCKET, RI, 028602576, US | |||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||
| Phone | +1 401-305-0080 |
| Fax | 8666550696 |
Authorized person
| Name | TEMPERANCE TAYLOR |
| Role | OWNER |
| Phone | 4013050080 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 2083B0002X - Obesity Medicine (Preventive Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1164040069 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| TEMPERANCE TAYLOR | Agent | 400 WARREN AVENUE SUITE 2L-A, EAST PROVIDENCE, RI, 02914, USA |
| Number | Name | File Date |
|---|---|---|
| 202455414810 | Annual Report | 2024-06-06 |
| 202333625080 | Annual Report | 2023-04-22 |
| 202210949870 | Fictitious Business Name Statement | 2022-02-16 |
| 202210186950 | Annual Report | 2022-02-13 |
| 202209926820 | Annual Report | 2022-02-09 |
| 202106131390 | Revocation Notice For Failure to File An Annual Report | 2021-12-03 |
| 202188436020 | Annual Report | 2021-02-04 |
| 202044070050 | Statement of Change of Registered/Resident Agent Office | 2020-07-02 |
| 202033982410 | Fictitious Business Name Statement | 2020-02-09 |
| 201914172540 | Articles of Organization | 2019-08-21 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
