Organization
THE DEVEREUX FOUNDATION
Active
Other names
Devereux Advanced Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLE CIRRUCCI (DIRECTOR OF FINANCE)
(856) 599-6429
Entity
Organization
Contact information
Practice address
3 POTSDAM COURT, GLASSBORO, NJ 08028
(856) 599-6400
(856) 599-6404
Mailing address
286 MANTUA GROVE ROAD, WEST DEPTFORD, NJ 08066
(856) 599-6400
(856) 599-6404
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
GH857
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0399507
—
NJ
Enumeration date
04/19/2017
Last updated
04/19/2017
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