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Organization
DEVEREUX FOUNDATION
Active
Organization
DEVEREUX FOUNDATION
Active
Other names
Kanner Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FRAN WAGNER (NATIONAL DIRECTOR, AR)
(610) 542-3084
Entity
Organization
Contact information
Practice address
390 E BOOT RD, WEST CHESTER, PA 19380-1222
(610) 431-8100
(610) 431-8191
Mailing address
390 E BOOT RD, WEST CHESTER, PA 19380-1222
(610) 431-8100
(610) 431-8191
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
188810
PA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
126010
PA
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010499
—
NJ
05
—
100019130366
—
PA
Enumeration date
12/12/2006
Last updated
06/09/2011
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