# TAYLOR HOME

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RENU LIFE, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558596536
- **Legal business name:** RENU LIFE, LLC
- **Authorized official:** MRS. DIANE HARRISON (PRESIDENT)
- **Authorized official phone:** (919) 734-0266

## Contact information

- **Practice address:** 802 TAYLOR ST, GOLDSBORO, NC 27534
- **Practice address phone:** (919) 734-0266
- **Practice address fax:** (919) 734-9926
- **Mailing address:** PO BOX 1017, GOLDSBORO, NC 27533-1017
- **Mailing address phone:** (919) 734-0266
- **Mailing address fax:** (919) 734-9926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-096-109 | NC | Yes |

## Other

- **Enumeration date:** 05/20/2009
- **Last updated:** 05/20/2009