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General NPI Number Information
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NPI Number | 1417753252
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Entity Type | Organization
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Legal Business Name | GARDEN BROOKE, LLC
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 9430 5TH ST
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City | CRAWFORD
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State | TX
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Zip | 76638-3105
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Country | US
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Telephone | 254-450-0893
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Fax |
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Provider Business Mailing Address
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Address Line | 1227 N VALLEY MILLS DR STE 233
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City | WACO
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State | TX
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Zip | 76710-4447
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DUSTIN RAUCH
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Credential |
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Telephone | 254-450-0893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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