Organization
DEVEREUX FOUNDATION
Active
Other names
Devereux Whitlock Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FRAN WAGNER (NATIONAL ACCTS REIVABLE DIRECTOR)
(610) 542-3084
Entity
Organization
Contact information
Practice address
806 MAPLE AVE, BERWYN, PA 19312-1726
(610) 296-6800
(610) 251-2013
Mailing address
139 LEOPARD RD, BERWYN, PA 19312-1809
(610) 296-6800
(610) 251-2013
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
504260
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000019130350
—
PA
Enumeration date
02/08/2007
Last updated
08/22/2020
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