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Phabian Treyvonne Dejean
Assisted Living Facility (Mental Illness) in Kaukauna, Wisconsin
NPI 1346950698

Phabian Treyvonne Dejean is an Assisted Living Facility (Mental Illness) based in Kaukauna, WI and is specialized in Assisted Living, Mental Illness. Phabian Treyvonne Dejean practices in Kaukauna, WI. The NPI Number for Phabian Treyvonne Dejean is 1346950698 and holds a License No. 0019259 (Wisconsin).

The current practice location address for Phabian Treyvonne Dejean is 104 W 4Th St, Kaukauna, WI and can be reached out via phone at 920-809-1023.

Location: 104 W 4Th St, Kaukauna, WI, 54130-2447
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1346950698
Provider Name
Phabian Treyvonne Dejean
Credential
Provider Entity Type
Individual
Gender
Male
Address
104 W 4Th St, Kaukauna, WI, 54130-2447
Phone Number
920-809-1023
Fax Number
Provider Enumeration Date
11/28/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
104 W 4Th St
City
Kaukauna
State
Wisconsin
Zip
54130-2447
Phone Number
920-809-1023
Fax Number
person
Provider Business Mailing Address Details
Address
104 W 4Th St
City
Kaukauna
State
Wisconsin
Zip
54130-2447
Phone Number
920-809-1023
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
Assisted Living, Mental Illness
Taxonomy
3104A0625X
License No.
0019259 (Wisconsin)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
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