Provider Demographics
NPI:1093353427
Name:MEDI-SSAGE HEALTH INC.
Entity Type:Organization
Organization Name:MEDI-SSAGE HEALTH INC.
Other - Org Name:MEDI-SSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ED & FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ARRICKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT,MMP,PSS
Authorized Official - Phone:480-770-4606
Mailing Address - Street 1:1480 E PECOS RD APT 2038
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1838
Mailing Address - Country:US
Mailing Address - Phone:480-479-5003
Mailing Address - Fax:480-546-5199
Practice Address - Street 1:555 N 18TH ST STE 301
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-3759
Practice Address - Country:US
Practice Address - Phone:480-770-4606
Practice Address - Fax:480-546-5199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain