Provider Demographics
NPI:1962977892
Name:IMAGINING THE GARDEN LLC
Entity type:Organization
Organization Name:IMAGINING THE GARDEN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOJERSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-496-2167
Mailing Address - Street 1:8014 RICHARD RD
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-1241
Mailing Address - Country:US
Mailing Address - Phone:216-496-2167
Mailing Address - Fax:
Practice Address - Street 1:3505 E ROYALTON ROAD #201
Practice Address - Street 2:SUITE 201
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-4414
Practice Address - Country:US
Practice Address - Phone:216-716-7777
Practice Address - Fax:216-716-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty