NPIMap

Organization Active NPI

Devereux Foundation, Inc.

Doing business as Devereux Advanced Behavioral Health

  • Community Health Clinic/Center
  • Bartow, FL
National Provider Identifier
1407631856
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
DEVEREUX FOUNDATION, INC.
Doing business as
Devereux Advanced Behavioral Health
Practice address
3350 State Road 60 E
Bartow, FL 33830-8471
Phone
(813) 460-4451
NPI assigned
Aug 25, 2023
Last updated
Aug 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Authorized official

Name
Jessica Lyles
Title
National Director of Accounts Recei
Phone
(267) 637-4536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU Primary

Addresses

Primary practice location

3350 State Road 60 E
Bartow, FL 33830-8471

Mailing address

5850 T G Lee Blvd Ste 400
Orlando, FL 32822-4409

Other names 1

  • Devereux Advanced Behavioral Health Doing business as

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1407631856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 T G LEE BLVD STE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328224409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 STATE ROAD 60 E",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338308471",
            "telephone_number": "813-460-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "LYLES",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "NATIONAL DIRECTOR OF ACCOUNTS RECEI",
        "authorized_official_telephone_number": "267-637-4536"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devereux Advanced Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bartow, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.