The Devereux Foundation
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Mantua, NJ. Organization (NPI-2).
NPI number1437683034
StatusActive
Last updated in NPPESApr 20, 2017
Details
- NPI
- 1437683034
- Entity type
- Organization (NPI-2)
- Legal business name
- The Devereux Foundation
- Organization subpart
- No
- Enumeration date
- Apr 20, 2017
- Last updated
- Apr 20, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | GH1564 | NJ | Yes |
Other names
- Devereux Advanced Behavioral Health (Doing Business As)
Practice location
651 Topeka AvenueMantua, NJ 08051
Phone 856-599-6400 · Fax 856-599-6404
Mailing address
286 Mantua Grove RoadWest Deptford, NJ 08066
Phone 856-599-6400 · Fax 856-599-6404
Authorized official
Carole Cirucci
Director Of Finance
8565996429
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