Healthcare Provider Details

I. General information

NPI: 1578367835
Provider Name (Legal Business Name): GARDEN OF FRIENDS FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26960 CHERRY HILLS BLVD STE B
SUN CITY CA
92586-2512
US

IV. Provider business mailing address

26960 CHERRY HILLS BLVD STE B
SUN CITY CA
92586-2512
US

V. Phone/Fax

Practice location:
  • Phone: 951-772-6145
  • Fax:
Mailing address:
  • Phone: 951-772-6145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EDWARD K MASON
Title or Position: BILLING MANAGER
Credential:
Phone: 530-868-6944