NPIMap

Organization Active NPI

Devereux Foundation

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Victoria, TX
National Provider Identifier
1609958628
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
5460 Issued in TX
Legal business name
DEVEREUX FOUNDATION
Practice address
120 David Wade Drive
Victoria, TX 77905
Phone
(361) 575-8271
Fax
(361) 575-6520
NPI assigned
Oct 19, 2006
Organization subpart
Yes
Parent organization
DEVEREUX FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Authorized official

Name
Ms. Pamela E. Helm
Title
Executive Director
Phone
(281) 335-1000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 5460 TX Primary

Addresses

Primary practice location

120 David Wade Drive
Victoria, TX 77905

Mailing address

PO Box 2666
Victoria, TX 77902-2666
Phone (361) 575-8271

Other identifiers 2

IdentifierTypeStateIssuer
112748201MedicaidTX
112748202MedicaidTX

Other names 1

  • Devereux Texas Treatment Network Doing business as

National Provider Directory

National Provider Directory
Part of
Devereux Florida

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247529600000",
    "number": "1609958628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2666",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779022666",
            "telephone_number": "361-575-8271",
            "fax_number": "361-575-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DAVID WADE DRIVE",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "77905",
            "telephone_number": "361-575-8271",
            "fax_number": "361-575-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEVEREUX FOUNDATION",
        "enumeration_date": "2006-10-19",
        "last_updated": "2009-07-14",
        "status": "A",
        "authorized_official_last_name": "HELM",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "281-335-1000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "TX",
            "license": "5460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112748201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112748202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devereux Texas Treatment Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.