| NPI | 1619414232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CESAR FABIANI Suboxone Maintenance Doctor 126-769-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |