Organization
THE DEVEREUX FOUNDATION
Active
Other names
PA CIDDS-King Road B
Organization subpart
No
Provider details
NPI number
Authorized official
DENISHA HALL (REIMBURSEMENT ANALYST)
(610) 542-3042
Entity
Organization
Contact information
Practice address
791B KING RD, WEST CHESTER, PA 19380-1418
(610) 542-3042
Mailing address
2012 RENAISSANCE BLVD, KING OF PRUSSIA, PA 19406-2786
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
131520
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000019130727
—
PA
Enumeration date
02/23/2015
Last updated
02/23/2015
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