DEFONSE FAMILY RESTORATION LLC NPI 1568087716

NPI Information

NPI: 1568087716
Provider Name: DEFONSE FAMILY RESTORATION LLC
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
7812 W WOOD LN
PHOENIX, AZ
ZIP 85043
Phone: (310) 956-7616
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DEFONSE FAMILY RESTORATION LLC is a community based residential treatment facility mental illness in Phoenix, AZ. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. DEFONSE FAMILY RESTORATION LLC NPI is 1568087716. The provider is registered as an organization entity type.

The provider's business location address is:

7812 W WOOD LN
PHOENIX, AZ
ZIP 85043-426
Phone: (310) 956-7616

The provider's authorized official is Nadine Defonse Fanfan .
The authorized official title is Asst Administrator/manager and has the following contact phone number (323) 412-2137.

The enumeration date for this NPI number is 6/13/2020 and was last updated on 6/13/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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