Defonse Family Restoration LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

DEFONSE FAMILY RESTORATION LLC

Practice address

7812 W Wood LN
Phoenix, AZ 85043-1426

Phone

(310) 956-7616

NPI assigned

Jun 13, 2020

Last updated

Jun 13, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nadine Defonse Fanfan

Title

Asst Administrator/Manager

Phone

(323) 412-2137

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Closel Defonse

  • Behavior Technician
  • Phoenix, AZ
  • NPI 1073136719
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592006400000",
    "number": "1568087716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7812 W WOOD LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850431426",
            "telephone_number": "310-956-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7812 W WOOD LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850431426",
            "telephone_number": "310-956-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEFONSE FAMILY RESTORATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-13",
        "last_updated": "2020-06-13",
        "certification_date": "2020-06-13",
        "status": "A",
        "authorized_official_last_name": "DEFONSE FANFAN",
        "authorized_official_first_name": "NADINE",
        "authorized_official_title_or_position": "ASST ADMINISTRATOR/MANAGER",
        "authorized_official_telephone_number": "323-412-2137"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alio Mbiale Deeyor, FNP-BC
• Sorka Deeyor, MD
• George Anthony Defabritis, D.C.
• Matthew Adam Defelice, D.D.S.
• Hilda Margaret Defoe, FNP-C
• Closel Defonse
• Jennifer Degain, PMHNP-BC
• Erendira Johana Degante
• Jim Degiuli, L.AC.
• Elizabeth Degnan, FNP-C

• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.