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General NPI Number Information
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NPI Number | 1548547649
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Entity Type | Organization
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Legal Business Name | THE DEVEREUX FOUNDATION
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Dates
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Enumeration Date | 11/03/2011
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 6411 E EUGIE TER
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-3963
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Country | US
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Telephone | 480-998-2920
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Fax |
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Provider Business Mailing Address
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Address Line | 11000 N SCOTTSDALE RD STE 260
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-6200
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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 | LEAD FINANCIAL SPECIALIST
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Name | SOPHIE PARK
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Credential |
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Telephone | 480-889-0569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number | BH3881
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License Number State | AZ
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