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NPI Code Detail

MEDICARE: UNICORN GARDEN, INC.

MEDICARE: UNICORN GARDEN, 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
1253J00000XFoster Care Agency
2322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number : 1710522206
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNICORN GARDEN, INC.
Provider Business Mailing Address
First Line : 3817 EDITH LN
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93304-6703
Country : US
Telephone Number : 661-834-7789
Fax Number : 661-834-2340
Provider Business Practice Location Address
First Line : 3817 EDITH LN
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93304-6703
Country : US
Telephone Number : 661-834-7789
Fax Number : 661-834-2340
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : KIM HUDNALL
Credential :
Telephone Number : 661-834-7789
Provider Enumeration Date : 11/08/2019
Last Update Date : 11/08/2019

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