NPIMap

Organization Active NPI

The Devereux Foundation

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • West Deptford, NJ
National Provider Identifier
1902132111
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
THE DEVEREUX FOUNDATION
Practice address
286 Mantua Grove Rd
Building 4
West Deptford, NJ 08066-1738
Phone
(856) 599-6400
Fax
(856) 599-6401
NPI assigned
Oct 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Authorized official

Name
Ms. Fran Wagner
Title
National Director Ar
Phone
(610) 542-3084

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NJ Primary

Addresses

Primary practice location

286 Mantua Grove Rd
Building 4
West Deptford, NJ 08066-1738

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0203246MedicaidNJ

Other names 1

  • Devereux NJ Other name

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1902132111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 MANTUA GROVE RD",
            "address_2": "BUILDING 4",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080661738",
            "telephone_number": "856-599-6400",
            "fax_number": "856-599-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 MANTUA GROVE RD",
            "address_2": "BUILDING 4",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080661738",
            "telephone_number": "856-599-6400",
            "fax_number": "856-599-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DEVEREUX FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-22",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "FRAN",
        "authorized_official_title_or_position": "NATIONAL DIRECTOR AR",
        "authorized_official_telephone_number": "610-542-3084",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0203246",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devereux NJ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Deptford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.