Professional Associates in Rehabilitation LLC

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

330225 Issued in MI

Legal business name

PROFESSIONAL ASSOCIATES IN REHABILITATION LLC

Practice address

3960 Patient Care Way
Ste. 104
Lansing, MI 48911-4275

Phone

(517) 887-9801

Fax

(517) 887-9826

NPI assigned

Feb 13, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert J Fabiano, PHD

Title

Executive Director

Phone

(517) 887-9801

Specialties & licenses 3

Addresses

Other names 1

• PAR Rehab Services Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1285907899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 COVINGTON CT",
            "address_2": "STE. 201",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124941",
            "telephone_number": "517-371-4971",
            "fax_number": "517-371-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 PATIENT CARE WAY",
            "address_2": "STE. 104",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114275",
            "telephone_number": "517-887-9801",
            "fax_number": "517-887-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ASSOCIATES IN REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "FABIANO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "517-887-9801",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "330225",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAR Rehab Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.