MEDICARE: THE GARDEN FOUNDATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251V00000X	Voluntary or Charitable Agency
2	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1063099794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GARDEN FOUNDATION INC

Provider Business Mailing Address
First Line	:	7485 W AZURE DR STE 130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-4422
Country	:	US
Telephone Number	:	702-488-7566
Fax Number	:

Provider Business Practice Location Address
First Line	:	7485 W AZURE DR STE 130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-4422
Country	:	US
Telephone Number	:	702-488-7566
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER & CEO
Name	:	TAYLOR GARDNER
Credential	:
Telephone Number	:	702-488-7566

Provider Enumeration Date	:	03/27/2021
Last Update Date	:	04/26/2021

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Directions to “THE GARDEN FOUNDATION INC ” Practice Location

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