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Medmark Treatment Centers- Fairfield, Inc.
Methadone Clinic in Fairfield, California
NPI 1669534491

Medmark Treatment Centers- Fairfield, Inc. is a Methadone Clinic based in Lewisville, CA and is specialized in Methadone. Medmark Treatment Centers- Fairfield, Inc. practices in Fairfield, CA. The NPI Number for Medmark Treatment Centers- Fairfield, Inc. is 1669534491 and holds a License No. 48-03 (California).

The current practice location address for Medmark Treatment Centers- Fairfield, Inc. is 1143 Missouri Street, Fairfield, CA and can be reached out via phone at 707-435-9911 and via fax at 707-435-0704.

Location: 1143 Missouri Street, Fairfield, CA, 75057-6425
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1669534491
Provider Name
Medmark Treatment Centers- Fairfield, Inc.
Credential
Provider Entity Type
Organization
Address
1143 Missouri Street, Fairfield, CA, 75057-6425
Phone Number
707-435-9911
Fax Number
707-435-0704
Provider Enumeration Date
12/15/2006
Last Update Date
08/17/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
48AA 05 CA
48AA 01 CA MEDI-CAL
institution
Provider Business Practice Location Address Details
Address
1143 Missouri Street
City
Fairfield
State
California
Zip
94533-6007
Phone Number
707-435-9911
Fax Number
707-435-0704
person
Provider Business Mailing Address Details
Address
1143 Missouri Street
City
Fairfield
State
California
Zip
94533-6007
Phone Number
707-435-9911
Fax Number
707-435-0704
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Methadone
Taxonomy
261QM2800X
License No.
48-03 (California)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
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