Anthony Defazio, Lcadc LLC
Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children in Wall, New Jersey
1578345914- Practice location
- 1540 Rte 138 Ste 201, Wall, NJ 07719-3765
- Phone
- 732-984-1263
- Fax
- 732-515-9159
- Last updated
- October 19, 2023
Anthony Defazio, Lcadc LLC is a healthcare organization based in Wall, NJ. Anthony Defazio, Lcadc LLC practices in Wall, NJ. The NPI Number for Anthony Defazio, Lcadc LLC is 1578345914. The current practice location address for Anthony Defazio, Lcadc LLC is 1540 Rte 138 Ste 201, Wall, NJ 07719-3765 and can be reached out via phone at 732-984-1263 and via fax at 732-515-9159.
Provider Profile Details
- NPI Number
- 1578345914
- Provider Name
- Anthony Defazio, Lcadc LLC
- Provider Entity Type
- Organization
- Address
- 1540 Rte 138 Ste 201, Wall, NJ 07719-3765
- Phone Number
- 732-984-1263
- Fax Number
- 732-515-9159
- Primary Taxonomy
- Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children · 3245S0500X
- Organization Subpart
- No
- Authorized Official
- Anthony J Defazio, LCADC · Owner · 173-298-4126
- Other Names
- Anthony Defazio, Lcadc LLC (Doing Business As)
- Provider Enumeration Date
- October 19, 2023
- Last Update Date
- October 19, 2023
- Certification Date
- October 19, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1540 Rte 138 Ste 201
Wall, NJ 07719-3765 - City
- Wall
- State
- New Jersey
- Zip
- 07719-3765
- Phone Number
- 732-984-1263
- Fax Number
- 732-515-9159
Provider Business Mailing Address Details
- Address
- 1540 Rte 138 Ste 201
Wall, NJ 07719-3765 - City
- Wall
- State
- NJ
- Zip
- 07719-3765
- Phone Number
- 732-984-1263
- Fax Number
- 732-515-9159
License Information
- Taxonomy
- Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children · 3245S0500X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Anthony Defazio, Lcadc LLC?
The NPI number of Anthony Defazio, Lcadc LLC is 1578345914. It was assigned on October 19, 2023 and is currently active in the NPPES registry.
What is the specialty of Anthony Defazio, Lcadc LLC?
Anthony Defazio, Lcadc LLC is registered under the primary taxonomy Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (code 3245S0500X).
Where does Anthony Defazio, Lcadc LLC practice?
The practice location is 1540 Rte 138 Ste 201, Wall, NJ 07719-3765. The office can be reached at 732-984-1263 (phone) or 732-515-9159 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1578345914 directly on the NPPES registry website.