MEDICARE: THE GARDEN OF FEEDIN', 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	225100000X	Physical Therapist
2	235Z00000X	Speech-Language Pathologist	SLP0188	AZ
3	225X00000X	Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174729289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GARDEN OF FEEDIN', INC.

Provider Business Mailing Address
First Line	:	PO BOX 82098
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85071-2098
Country	:	US
Telephone Number	:	602-412-3736
Fax Number	:

Provider Business Practice Location Address
First Line	:	1031 W INDIAN HILLS PL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-6278
Country	:	US
Telephone Number	:	602-412-3736
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	COLLEEN HART
Credential	:	MACCCSLP
Telephone Number	:	602-412-3736

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	09/11/2025

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Directions to “THE GARDEN OF FEEDIN', INC. ” Practice Location

Language	Start Address	Practice Location

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