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Organization
DEVEREUX FOUNDATION, INC.
Active
Organization
DEVEREUX FOUNDATION, INC.
Active
Other names
Devereux Advanced Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LYLES (NATIONAL DIRECTOR OF ACCOUNTS RECEI)
(267) 637-4536
Entity
Organization
Contact information
Practice address
3350 STATE ROAD 60 E, BARTOW, FL 33830-8471
(813) 460-4451
Mailing address
5850 T G LEE BLVD STE 400, ORLANDO, FL 32822-4409
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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