NPIMap

Organization Active NPI

Devereux Cidds Donovan

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • West Chester, PA
National Provider Identifier
1073940177
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
132890 Issued in PA
Legal business name
DEVEREUX CIDDS DONOVAN
Practice address
390 E Boot Rd
102 Genuardi Circle
West Chester, PA 19380-1222
Phone
(610) 431-8100
NPI assigned
Oct 3, 2013
Last updated
Oct 3, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
DEVEREUX FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Authorized official

Name
Ms. Fran Wagner
Title
National Director of Accounts Recei
Phone
(610) 542-3084

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 132890 PA Primary

Addresses

Primary practice location

390 E Boot Rd
102 Genuardi Circle
West Chester, PA 19380-1222

Mailing address

390 E Boot Rd
102 Genuardi Circle
West Chester, PA 19380-1222
Phone (610) 431-8100

Other identifiers 2

IdentifierTypeStateIssuer
1000019130621MedicaidPA
1000019130725MedicaidPA

Other names 1

  • Devereux Foundation Other name

National Provider Directory

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

Organizations with this tax ID in the same state 23

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

View all 23

Locations

390 E Boot Rd
#102
West Chester, PA 19380
Phone (610) 431-8100

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1073940177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 E BOOT RD",
            "address_2": "102 GENUARDI CIRCLE",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193801222",
            "telephone_number": "610-431-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E BOOT RD",
            "address_2": "102 GENUARDI CIRCLE",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193801222",
            "telephone_number": "610-431-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX CIDDS DONOVAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEVEREUX FOUNDATION",
        "enumeration_date": "2013-10-03",
        "last_updated": "2013-10-03",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "FRAN",
        "authorized_official_title_or_position": "NATIONAL DIRECTOR OF ACCOUNTS RECEI",
        "authorized_official_telephone_number": "610-542-3084",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "PA",
            "license": "132890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000019130621",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000019130725",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devereux Foundation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.