Healthcare Provider Details

I. General information

NPI: 1144137951
Provider Name (Legal Business Name): DEVEREUX ADVANCED BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 SUNHAVEN DR
CLAYTON NJ
08312-1936
US

IV. Provider business mailing address

901 LINCOLN DR W
MARLTON NJ
08053-3131
US

V. Phone/Fax

Practice location:
  • Phone: 856-599-6400
  • Fax:
Mailing address:
  • Phone: 484-846-8987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JESSICA KALBACH
Title or Position: CONTRACT MANAGER
Credential:
Phone: 610-542-3042