Organization
DEVEREUX
Active
Other names
Devereux New Jersey
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FRAN WAGNER (CONTRACT DIRECTOR)
(610) 542-3084
Entity
Organization
Contact information
Practice address
286 MANTUA GROVE RD, BLDG #4, WEST DEPTFORD, NJ 08066-1738
(856) 599-6429
Mailing address
2012 RENAISSANCE BLVD, KING OF PRUSSIA, PA 19406-2786
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/05/2012
Last updated
12/05/2012
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