Devereux Foundation

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

DEVEREUX FOUNDATION

Practice address

442 Gallagher St SW
Palm Bay, FL 32908-4727

Phone

(321) 709-2164

NPI assigned

Feb 26, 2016

Organization subpart

No

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

Authorized official

Name

Steven J Murphy

Title

Executive Director

Phone

(407) 362-9210

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456444800000",
    "number": "1457711939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 GALLAGHER ST SW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329084727",
            "telephone_number": "321-709-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 GALLAGHER ST SW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329084727",
            "telephone_number": "321-709-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "407-362-9210"
    },
    "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": "672473696",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emmanuella Etienne Denis, EDD
• Tara Derakhshandeh, DMD
• Shekhar S Desai, MD
• Designing Big Dreams Inc
• Kimberly Deslauriers
• Devereux Foundation
• Kahla Bri Santiago Dewar
• Amma A Dewberry, BS
• Stephen Di Cerbo, LMFT
• Diagnostic Portable Imaging Inc

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.