Provider Demographics
NPI:1013575638
Name:THE REGENERATION PROJECT LLC
Entity Type:Organization
Organization Name:THE REGENERATION PROJECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RODDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:CPRP
Authorized Official - Phone:410-254-6175
Mailing Address - Street 1:2701 N CHARLES ST STE 401
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5061
Mailing Address - Country:US
Mailing Address - Phone:410-254-6175
Mailing Address - Fax:
Practice Address - Street 1:2701 N CHARLES ST STE 401
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5061
Practice Address - Country:US
Practice Address - Phone:410-254-6175
Practice Address - Fax:410-254-6175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health