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Organization
DEVEREUX FOUNDATION
Active
Organization
DEVEREUX FOUNDATION
Active
Other names
Devereux Florida - Titusville RGC Cottage
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWEN SKINNER (EXECUTIVE DIRECTOR)
(407) 362-9210
Entity
Organization
Contact information
Practice address
1135 DAY ST, TITUSVILLE, FL 32780-2641
(407) 362-9210
Mailing address
5850 T G LEE BLVD STE 400, ORLANDO, FL 32822-4409
(407) 362-9210
(610) 542-3191
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
Other
Enumeration date
02/28/2018
Last updated
03/29/2018
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