NPIMap

Organization Active NPI

Devereux Foundation

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Hillsborough, NJ
National Provider Identifier
1639656705
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
GH0970 Issued in NJ
Legal business name
DEVEREUX FOUNDATION
Practice address
124 Wertsville Rd
Hillsborough, NJ 08844-3908
Phone
(856) 599-6400
NPI assigned
Jul 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Authorized official

Name
Paul McNeill
Title
Assistant Finance Director
Phone
(856) 599-6230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X GH0970 NJ Primary

Addresses

Primary practice location

124 Wertsville Rd
Hillsborough, NJ 08844-3908

Mailing address

286 Mantua Grove Rd BLDG 4
West Deptford, NJ 08066-1738
Phone (856) 599-6400

Other identifiers 1

IdentifierTypeStateIssuer
0399507MedicaidNJ

Other names 1

  • Devereux Advanced Behavioral Health Doing business as

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

124 Wertsville Rd
Hillsborough, NJ 08844

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1639656705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 MANTUA GROVE RD BLDG 4",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080661738",
            "telephone_number": "856-599-6400",
            "fax_number": "856-599-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 WERTSVILLE RD",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088443908",
            "telephone_number": "856-599-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "MCNEILL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "ASSISTANT FINANCE DIRECTOR",
        "authorized_official_telephone_number": "856-599-6230"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NJ",
            "license": "GH0970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0399507",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devereux Advanced Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Devereux Advanced Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hillsborough, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.