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The Devereux Foundation

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Bridgeton, NJ

NPI 1205360245 · NPPES record last updated Apr 17, 2017

Key facts

NPI
1205360245
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
GH394 (NJ)
Legal business name
THE DEVEREUX FOUNDATION
Practice address
50 Roberts Avenue
Bridgeton, NJ 08302
Phone
(856) 599-6400
Fax
(856) 599-6404
NPI assigned
Apr 17, 2017
Organization subpart
No

Authorized official

Name
Ms. Carole Cirucci
Title
Director of Finance
Phone
(856) 599-6429

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Devereux Florida (331 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X GH394 NJ Yes

Addresses

Primary practice location

50 Roberts Avenue
Bridgeton, NJ 08302

Mailing address

286 Mantua Grove Road
West Deptford, NJ 08066
Phone (856) 599-6400

Other identifiers

IdentifierTypeStateIssuer
0399507MedicaidNJ

Other names

  • Devereux Advanced Behavioral Health Doing business as

Other providers in Bridgeton, NJ

All providers in Bridgeton, NJ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

Sources for this page

Verify at the official NPI Registry.