NPIMap

Organization Active NPI

Devereux NJ Reach Treatment Home

  • Mental Illness Community Based Residential Treatment Facility
  • Freehold, NJ
National Provider Identifier
1265620934
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
DEVEREUX NJ REACH TREATMENT HOME
Practice address
4251 Route 9 N
Freehold, NJ 07728-8303
Phone
(732) 625-9600
Fax
(610) 542-3191
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Authorized official

Name
Fran Wagner
Title
National Director, a/R
Phone
(610) 542-3084

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NJ Primary

Addresses

Primary practice location

4251 Route 9 N
Freehold, NJ 07728-8303

Mailing address

4251 Route 9 N
Freehold, NJ 07728-8303
Phone (732) 625-9600

Other identifiers 1

IdentifierTypeStateIssuer
0119873MedicaidNJ

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

4251 US Highway 9
Freehold, NJ 07728
Phone (732) 577-1855

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1265620934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 ROUTE 9 N",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288303",
            "telephone_number": "732-625-9600",
            "fax_number": "610-542-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 ROUTE 9 N",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288303",
            "telephone_number": "732-625-9600",
            "fax_number": "610-542-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX NJ REACH TREATMENT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "FRAN",
        "authorized_official_title_or_position": "NATIONAL DIRECTOR, A/R",
        "authorized_official_telephone_number": "610-542-3084"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119873",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.