Organization
DEVEREUX FOUNDATION, INC.
Active
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, SUITE 400, ORLANDO, FL 32822
(407) 362-9210
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029573603
—
FL
Enumeration date
12/06/2006
Last updated
11/06/2023
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