Organization Active NPI

Devereux Advanced Behavioral Health

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Jackson, NJ
National Provider Identifier
1053117333
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
DEVEREUX ADVANCED BEHAVIORAL HEALTH
Practice address
384 Vath St
Jackson, NJ 08527-5216
Phone
(856) 599-6400
NPI assigned
Feb 19, 2025
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Eric Eberman
Title
Executive Director
Phone
(856) 599-6409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

384 Vath St
Jackson, NJ 08527-5216

Mailing address

1515 Burnt Mill Rd
Cherry Hill, NJ 08003-3637

National Provider Directory

National Provider Directory
Tax ID family
Comm SVCS of Devereux332 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1053117333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 BURNT MILL RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080033637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 VATH ST",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085275216",
            "telephone_number": "856-599-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX ADVANCED BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "EBERMAN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "856-599-6409"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.