=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356205710
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PASA WELLNESS CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/10/2025
-----------------------------------------------------
Last Update Date | 12/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23332 FARMINGTON RD
-----------------------------------------------------
City | FARMINGTON HILLS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48336-9991
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-378-9567
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23332 FARMINGTON RD
-----------------------------------------------------
City | FARMINGTON HILLS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48336-9991
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-378-9567
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | PAMELA M OBARE
-----------------------------------------------------
Credential | FNP/PMHNP
-----------------------------------------------------
Telephone | 313-378-9567
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2083P0901X
-----------------------------------------------------
Taxonomy Name | Public Health & General Preventive Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------