NPIMap

Organization Active NPI

Devereux Foundation

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Somerset, NJ
National Provider Identifier
1174909469
Registry record updated May 9, 2017
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 FOUNDATION
Practice address
370 Campus Dr
Suite 120
Somerset, NJ 08873-1128
Phone
(856) 599-6400
Fax
(856) 599-6404
NPI assigned
Aug 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Authorized official

Name
Mrs. Carole Cirucci
Title
Director of Finance
Phone
(610) 542-3084

Specialties & licenses 1

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

Addresses

Primary practice location

370 Campus Dr
Suite 120
Somerset, NJ 08873-1128

Mailing address

286 Mantua Grove Rd
Building #4
West Deptford, NJ 08066-1738
Phone (856) 599-6400

Other identifiers 1

IdentifierTypeStateIssuer
0399507MedicaidNJ

Other names 1

  • Devereux Advanced Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Devereux Florida331 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Locations

370 Campus Dr
Ste 120
Somerset, NJ 08873

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494288000000",
    "number": "1174909469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 MANTUA GROVE RD",
            "address_2": "BUILDING #4",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080661738",
            "telephone_number": "856-599-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 CAMPUS DR",
            "address_2": "SUITE 120",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731128",
            "telephone_number": "856-599-6400",
            "fax_number": "856-599-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-10",
        "last_updated": "2017-05-09",
        "status": "A",
        "authorized_official_last_name": "CIRUCCI",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "610-542-3084",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0399507",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devereux Advanced Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.