# DEVEREUX FOUNDATION, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Devereux Advanced Behavioral Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407631856
- **Authorized official:** JESSICA LYLES (NATIONAL DIRECTOR OF ACCOUNTS RECEI)
- **Authorized official phone:** (267) 637-4536

## Contact information

- **Practice address:** 3350 STATE ROAD 60 E, BARTOW, FL 33830-8471
- **Practice address phone:** (813) 460-4451
- **Mailing address:** 5850 T G LEE BLVD STE 400, ORLANDO, FL 32822-4409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/25/2023
- **Last updated:** 08/25/2023