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Anthony Defazio, Lcadc Llc
Children's Substance Abuse Rehabilitation Facility in Wall, New Jersey
NPI 1578345914

Anthony Defazio, Lcadc Llc is a Children's Substance Abuse Rehabilitation Facility based in Wall, NJ and is specialized in Substance Abuse Treatment, Children. Anthony Defazio, Lcadc Llc practices in Wall, NJ. The NPI Number for Anthony Defazio, Lcadc Llc is 1578345914 and holds a License No. (New Jersey).

The current practice location address for Anthony Defazio, Lcadc Llc is 1540 Rte 138 Ste 201, Wall, NJ and can be reached out via phone at 732-984-1263 and via fax at 732-515-9159.

Location: 1540 Rte 138 Ste 201, Wall, NJ, 07719-3765
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1578345914
Provider Name
Anthony Defazio, Lcadc Llc
Credential
Provider Entity Type
Organization
Address
1540 Rte 138 Ste 201, Wall, NJ, 07719-3765
Phone Number
732-984-1263
Fax Number
732-515-9159
Provider Enumeration Date
10/19/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1540 Rte 138 Ste 201
City
Wall
State
New Jersey
Zip
07719-3765
Phone Number
732-984-1263
Fax Number
732-515-9159
person
Provider Business Mailing Address Details
Address
1540 Rte 138 Ste 201
City
Wall
State
New Jersey
Zip
07719-3765
Phone Number
732-984-1263
Fax Number
732-515-9159
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
Substance Abuse Treatment, Children
Taxonomy
3245S0500X
License No.
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Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.
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