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General NPI Number Information
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NPI Number | 1164901351
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Entity Type | Organization
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Legal Business Name | DEVEREUX FOUNDATION
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Dates
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Enumeration Date | 08/09/2018
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 1601 - 1603 SICKLERVILLE ROAD
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City | SICKLERVILLE
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State | NJ
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Zip | 08081
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Country | US
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Telephone | 856-599-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 286 MANTUA GROVE RD
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City | WEST DEPTFORD
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State | NJ
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Zip | 08066-1738
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT FIANCE DIRECTOR
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Name | PAUL MCNEILL
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Credential |
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Telephone | 856-599-6230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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