Provider Demographics
NPI:1700028008
Name:ABERDIUM5, LLC
Entity Type:Organization
Organization Name:ABERDIUM5, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBARN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:919-357-8305
Mailing Address - Street 1:222 OLD FAYETTEVILLE RD
Mailing Address - Street 2:D-202
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-5503
Mailing Address - Country:US
Mailing Address - Phone:919-357-8305
Mailing Address - Fax:
Practice Address - Street 1:222 OLD FAYETTEVILLE RD
Practice Address - Street 2:D202
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-5506
Practice Address - Country:US
Practice Address - Phone:919-357-8305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty