Healthcare Provider Details

I. General information

NPI: 1073426748
Provider Name (Legal Business Name): DEVEREUX NEW MEXICO FOSTER CARE CHILD PLACING AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 ALAMO AVE SE STE 300
ALBUQUERQUE NM
87106-3523
US

IV. Provider business mailing address

6141 E GRANT RD BLDG A
TUCSON AZ
85712-5829
US

V. Phone/Fax

Practice location:
  • Phone: 602-708-0240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: YVETTE JACKSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 520-576-5765