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General NPI Number Information
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NPI Number | 1073471520
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Entity Type | Organization
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Legal Business Name | GARDEN REFUGE INC NFP
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 850 S SPRING ST STE B
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City | SPRINGFIELD
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State | IL
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Zip | 62704-2618
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Country | US
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Telephone | 217-610-2620
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Fax |
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Provider Business Mailing Address
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Address Line | 850 S SPRING ST STE B
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City | SPRINGFIELD
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State | IL
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Zip | 62704-2618
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Country | US
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Telephone | 217-610-2620
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | TAKOUHIE ARAXIE JENSEN
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Credential |
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Telephone | 217-610-2620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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