Healthcare Provider Details

I. General information

NPI: 1508202920
Provider Name (Legal Business Name): ABARIS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 10/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 ROCHESTER CT
TROY MI
48083-1875
US

IV. Provider business mailing address

8391 COMMERCE RD SUITE 103
COMMERCE TOWNSHIP MI
48382-4489
US

V. Phone/Fax

Practice location:
  • Phone: 248-656-8500
  • Fax: 248-656-8600
Mailing address:
  • Phone: 248-363-3241
  • Fax: 248-636-2762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL SMITH
Title or Position: PRESIDENT
Credential: PHD
Phone: 248-656-8500