PHABIAN TREYVONNE DEJEAN
NPI 1346950698
Assisted Living Facility - Assisted Living, Mental Illness in Kaukauna, WI

Q: What is Phabian Dejean's NPI number?

The NPI number for Phabian Dejean is 1346950698. It was assigned to this individual provider in the NPPES registry on November 28, 2022.

Q: What is Phabian Dejean's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

Q: When was this NPI record last updated?

The NPPES record for Phabian Dejean was last updated on November 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 28, 2022

104 W 4TH ST, KAUKAUNA, WI 54130(920) 809-1023 Get Directions Write a Review

NPPES record last updated: November 28, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Phabian Treyvonne Dejean NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHABIAN TREYVONNE DEJEAN (NPI 1346950698) is an individual assisted living, mental illness provider in Kaukauna, Wisconsin, licensed in Wisconsin (0019259) and active in the NPI registry since November 2022.

NPPES Registry Identity

NPI1346950698

Entity TypeIndividualMale

Primary Taxonomy3104A0625X

Provider Legal NamePHABIAN TREYVONNE DEJEAN

Location Address104 W 4TH STKaukauna, WI 54130-2447

Mailing Address104 W 4th StKaukauna, WI 54130-2447 · (920) 809-1023

Phone(920) 809-1023

Sole ProprietorYes

Enumeration DateNovember 28, 2022

NPPES CertifiedNovember 10, 2022

✔ NPI 1346950698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Mental IllnessNursing & Custodial Care Facilities

Taxonomy Code3104A0625X

License✔ Licensed in WI · 0019259

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.

104 W 4TH ST, Kaukauna, WI 54130

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phabian Dejean's NPI number?

The NPI number for Phabian Dejean is 1346950698. It was assigned to this individual provider in the NPPES registry on November 28, 2022.

Where is Phabian Dejean located?

Phabian Dejean practices at 104 W 4th St, Kaukauna, WI 54130. The listed phone number is (920) 809-1023.

What is Phabian Dejean's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

When was this NPI record last updated?

The NPPES record for Phabian Dejean was last updated on November 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.