Organization
DEVEREUX NJ REACH TREATMENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRAN WAGNER (NATIONAL DIRECTOR, A/R)
(610) 542-3084
Entity
Organization
Contact information
Practice address
4251 ROUTE 9 N, FREEHOLD, NJ 07728-8303
(732) 625-9600
(610) 542-3191
Mailing address
4251 ROUTE 9 N, FREEHOLD, NJ 07728-8303
(732) 625-9600
(610) 542-3191
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119873
—
NJ
Enumeration date
10/09/2007
Last updated
10/09/2007
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