Organization
DEVEREUX RESIDENTIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NADINE WILLIAMS (BILLING CONSULTANT)
(919) 306-5751
Entity
Organization
Contact information
Practice address
115 MARKET ST, STE 204 G, DURHAM, NC 27701-3251
(919) 306-5751
(919) 321-1815
Mailing address
115 MARKET ST, STE 204 G, DURHAM, NC 27701-3251
(919) 306-5751
(919) 321-1815
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL032284
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL032284
NC
3747P1801X
Personal Care Attendant
Primary
MHL032284
NC
385H00000X
Respite Care
MHL032284
NC
Other
Enumeration date
03/09/2007
Last updated
09/05/2014
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