Devereux Foundation
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · South Harrison Township, NJ
NPI 1023675808 · NPPES record last updated May 28, 2019
Key facts
- NPI
- 1023675808
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- DEVEREUX FOUNDATION
- Practice address
- 440 Fislerville Rd
South Harrison Township, NJ 08062-4435 - Phone
- (856) 599-6400
- NPI assigned
- May 28, 2019
- Organization subpart
- No
Authorized official
- Name
- Carole Cirucci
- Title
- Director of Finance
- Phone
- (856) 599-6429
Corporate family (same tax ID) 14
National Provider Directory
- Tax ID family
- Devereux Florida
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
440 Fislerville Rd
South Harrison Township, NJ 08062-4435
Mailing address
286 Mantua Grove Rd
West Deptford, NJ 08066-1738
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0399507 | Medicaid | NJ |
Other names
- Devereux Advanced Behavioral Health
Other providers in South Harrison Township, NJ
All providers in South Harrison Township, NJ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.