PHABIAN TREYVONNE DEJEAN

KAUKAUNA, WI
NPI1346950698
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy3104A0625X Assisted Living Facility, Assisted Living, Mental Illness
(Licence: WI  0019259)
Enumeration Date2022-11-28
Last Update Date2022-11-28
Business Address
PHABIAN TREYVONNE DEJEAN
104 W 4TH ST
KAUKAUNA, WI 54130-2447
Phone number: 920-809-1023
Mailing Address
PHABIAN TREYVONNE DEJEAN
104 W 4TH ST
KAUKAUNA, WI 54130-2447
Phone number: 920-809-1023