NPIMap

Organization Active NPI

Polaris Detox LLC

  • Substance Abuse Rehabilitation Facility
  • Abbottstown, PA
National Provider Identifier
1801427687
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
POLARIS DETOX LLC
Practice address
7007 York Rd
Abbottstown, PA 17301-9774
Phone
(410) 773-0500
NPI assigned
Jan 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Authorized official

Name
Samuel Bierman
Title
Ceo
Phone
(410) 773-0500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

7007 York Rd
Abbottstown, PA 17301-9774

Mailing address

8600 Lasalle Rd.
Suite 212
Towson, MD 21286
Phone (410) 773-0500

Other names 1

  • Innovo Detox Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2213233Polaris Detox, LLC D/B/a Innovo Detox7007 York Road, Abbottstown, PA 17301Certificate of waiverFeb 10, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1801427687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 LASALLE RD.",
            "address_2": "SUITE 212",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21286",
            "telephone_number": "410-773-0500",
            "fax_number": "410-773-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7007 YORK RD",
            "city": "ABBOTTSTOWN",
            "state": "PA",
            "postal_code": "173019774",
            "telephone_number": "410-773-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLARIS DETOX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "BIERMAN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-773-0500"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovo Detox",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Innovo Detox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abbottstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.