Organization
THE DEVEREUX FOUNDATION
Active
Organization
THE DEVEREUX FOUNDATION
Active
Other names
PA CIDDS-Exton Station
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE DRY J.D. (REIMBURSEMENT ANALYST)
(610) 406-1637
Entity
Organization
Contact information
Practice address
984 ROUNDHOUSE CT, 2012 RENAISSANCE BOULEVARD, WEST CHESTER, PA 19380-1703
(610) 542-3074
(610) 542-3140
Mailing address
PO BOX 490A, 2012 RENAISSANCE BOULEVARD, VILLANOVA, PA 19085-0290
(610) 542-3074
(610) 542-3140
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
104200
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000019130716
—
PA
Enumeration date
08/22/2013
Last updated
08/22/2013
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