Provider Demographics
NPI:1871488205
Name:SONORAN WELLSPRING CARE LLC
Entity type:Organization
Organization Name:SONORAN WELLSPRING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AREA DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SABYASACHI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEYATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-884-1775
Mailing Address - Street 1:1255 N ARIZONA AVE UNIT 1286
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-0713
Mailing Address - Country:US
Mailing Address - Phone:404-884-1775
Mailing Address - Fax:
Practice Address - Street 1:1255 N ARIZONA AVE UNIT 1286
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-0713
Practice Address - Country:US
Practice Address - Phone:404-884-1775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care