MEDICARE: REGAN ROSE

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
1	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1215824826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGAN ROSE

Provider Business Mailing Address
First Line	:	8433 N BLACK CANYON HWY STE 184
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4859
Country	:	US
Telephone Number	:	480-690-1799
Fax Number	:

Provider Business Practice Location Address
First Line	:	8433 N BLACK CANYON HWY STE 184
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4859
Country	:	US
Telephone Number	:	480-690-1799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	01/05/2026

Similar Medicare Providers

1598011025 — AMBULATORY MEDICAL ASSOCIATES-CO, PLLC
Practice Location Address:

8433 N BLACK CANYON HWY STE 130
PHOENIX, AZ
85021-4859

Practice Phone: 602-687-8189
Practice Fax: 888-505-6003

1225792781 — HEART OF WINGS FAMILY SERVICES
Practice Location Address:

8433 N BLACK CANYON HWY STE 184
PHOENIX, AZ
85021-4859

Practice Phone: 602-299-7255
Practice Fax:

1588382360 — CHANGING LIVES FAMILY SERVICES, LLC
Practice Location Address:

8433 N BLACK CANYON HWY STE 200
PHOENIX, AZ
85021-4859

Practice Phone: 602-402-4474
Practice Fax:

1093433872 — A NEW PATH RECOVERY, LLC
Practice Location Address:

8433 N BLACK CANYON HWY STE 184
PHOENIX, AZ
85021-4859

Practice Phone: 602-402-4474
Practice Fax:

1699541177 — WRIGHT TO LEARN LLC.
Practice Location Address:

8433 N BLACK CANYON HWY STE 110
PHOENIX, AZ
85021-4859

Practice Phone: 602-755-3276
Practice Fax:

1003009382 — DR. DAVID JOSEPH DOPERAK DC
Practice Location Address:

4859 N 20TH ST
PHOENIX, AZ
85016-4707

Practice Phone: 602-689-0869
Practice Fax: 602-631-4427

Directions to “ REGAN ROSE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.