Organization
DEVEREUX FOUNDATION - WHITLOCK
Active
Other names
Whitlock PCH
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FRAN WAGNER (NATIONAL DIRECTOR, ACCTS RECEIVABLE)
(610) 542-3084
Entity
Organization
Contact information
Practice address
139 LEOPARD RD, BERWYN, PA 19312-1809
(610) 296-6800
Mailing address
133 LEOPARD RD, BERWYN, PA 19312-1809
(610) 296-6800
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
198110
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000019130005
—
PA
05
—
1000019130006
—
PA
Enumeration date
03/09/2007
Last updated
08/22/2020
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