Provider Demographics
NPI:1275034183
Name:REGENESIS HEALTHCARE, INC
Entity Type:Organization
Organization Name:REGENESIS HEALTHCARE, INC
Other - Org Name:ADD CLINIC OF ARIZONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SACHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIDDEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-773-5600
Mailing Address - Street 1:1108 W INDIAN SCHOOL RD STE B
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3115
Mailing Address - Country:US
Mailing Address - Phone:480-739-0007
Mailing Address - Fax:480-779-6289
Practice Address - Street 1:8675 S PRIEST DR STE 102
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1914
Practice Address - Country:US
Practice Address - Phone:480-739-0007
Practice Address - Fax:480-779-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty