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Organization
DEVEREUX CIDDS DONOVAN
Active
Organization
DEVEREUX CIDDS DONOVAN
Active
Parent organization
DEVEREUX FOUNDATION
Other names
Devereux Foundation
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEVEREUX FOUNDATION
Authorized official
MS. FRAN WAGNER (NATIONAL DIRECTOR OF ACCOUNTS RECEI)
(610) 542-3084
Entity
Organization
Contact information
Practice address
390 E BOOT RD, 102 GENUARDI CIRCLE, WEST CHESTER, PA 19380-1222
(610) 431-8100
Mailing address
390 E BOOT RD, 102 GENUARDI CIRCLE, WEST CHESTER, PA 19380-1222
(610) 431-8100
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
132890
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000019130621
—
PA
05
—
1000019130725
—
PA
Enumeration date
10/03/2013
Last updated
10/03/2013
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