Provider Demographics
NPI:1619414232
Name:FREEDOM BEHAVIORAL HEALTHCARE
Entity Type:Organization
Organization Name:FREEDOM BEHAVIORAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUBOXONE MAINTENANCE DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:
Authorized Official - Last Name:FABIANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:126-769-9300
Mailing Address - Street 1:1000 GERMANTOWN PIKE
Mailing Address - Street 2:BLDG G-5
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2480
Mailing Address - Country:US
Mailing Address - Phone:610-941-3390
Mailing Address - Fax:
Practice Address - Street 1:4612 E STREET RD
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6612
Practice Address - Country:US
Practice Address - Phone:267-699-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization