Devereux Residential Services LLC

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

MHL032284 Issued in NC

Legal business name

DEVEREUX RESIDENTIAL SERVICES LLC

Practice address

115 Market St
Ste 204 G
Durham, NC 27701-3251

Phone

(919) 306-5751

Fax

(919) 321-1815

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Nadine Williams

Title

Billing Consultant

Phone

(919) 306-5751

Specialties & licenses 4

Addresses

Tax ID family

Devereux Residential Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Devereux Residential Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Durham, NC
  • NPI 1730590035
  NPD tax ID
• Devereux Residential Services LLC

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1356474977
  NPD tax ID

Locations

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1487786190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MARKET ST",
            "address_2": "STE 204 G",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013251",
            "telephone_number": "919-306-5751",
            "fax_number": "919-321-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MARKET ST",
            "address_2": "STE 204 G",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013251",
            "telephone_number": "919-306-5751",
            "fax_number": "919-321-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "NADINE",
        "authorized_official_title_or_position": "BILLING CONSULTANT",
        "authorized_official_telephone_number": "919-306-5751",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL032284",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL032284",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "NC",
            "license": "MHL032284",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NC",
            "license": "MHL032284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Developmental Therapy Associates, Inc.
• Developmental Therapy Outreach Services
• Michael Dever
• Devereux Residential Services
• Devereux Residential Services LLC
• Tyson William Devereux, DC
• William Conrad Devereux, PHD, JD
• Deveta Garner
• Mary Devine
• Michael Joseph Devinney Jr., M.D./PH.D,

• Personal Care Attendant in Durham, NC
• Providers in Durham, NC by specialty
• Personal Care Attendant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.