Phabian Treyvonne Dejean
Phabian Treyvonne Dejean is an Assisted Living Facility (Mental Illness) in Kaukauna, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.
- Licensed in
- WI
- In the registry since
- 2022
Practice location Address checks out
104 W 4th StKaukauna, WI 54130-2447
Phone: (920) 809-1023
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Assisted Living Facility (Mental Illness) (primary) | Taxonomy 3104A0625X · Licence 0019259 (WI) |
|---|
Record details
| NPI number | 1346950698 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | November 28, 2022 |
| Last updated in NPPES | November 28, 2022 |
| Certification date | November 10, 2022 |