NPIMap

Organization Active NPI

Devereux Cleo Wallace

Doing business as Devereux Advanced Behavioral Health - Colorado

  • Psychiatric Residential Treatment Facility
  • Westminster, CO
National Provider Identifier
1053061150
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
DEVEREUX CLEO WALLACE
Doing business as
Devereux Advanced Behavioral Health - Colorado
Practice address
8405 Church Ranch Blvd
Westminster, CO 80021-3918
Phone
(610) 542-3064
NPI assigned
Mar 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Authorized official

Name
Bonnie Wright
Title
Quality Improvement Director
Phone
(303) 438-2265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

8405 Church Ranch Blvd
Westminster, CO 80021-3918

Mailing address

PO Box 74292
Cleveland, OH 44194-0002
Phone (610) 542-3064

Other names 1

  • Devereux Advanced Behavioral Health - Colorado Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Devereux Cleo Wallace4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1053061150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74292",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441940002",
            "telephone_number": "610-542-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8405 CHURCH RANCH BLVD",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800213918",
            "telephone_number": "610-542-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX CLEO WALLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "QUALITY IMPROVEMENT DIRECTOR",
        "authorized_official_telephone_number": "303-438-2265"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devereux Advanced Behavioral Health - Colorado",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westminster, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.