Organization
THE DEVEREUX FOUNDATION
Active
Other names
NJ Treatment Network - Intensive
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FRAN WAGNER (NATIONAL ACCOUNTS RECEIVABLE DIRECT)
(610) 542-3084
Entity
Organization
Contact information
Practice address
286 MANTUA GROVE RD, BUIDLING 4, PAULSBORO, NJ 08066-1731
(856) 599-6400
(856) 599-6401
Mailing address
286 MANTUA GROVE RD, BUIDLING 4, PAULSBORO, NJ 08066-1731
(856) 599-6400
(856) 599-6401
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
3000-035
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8833800
—
NJ
Enumeration date
01/31/2007
Last updated
08/22/2020
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