THE DEVEREUX FOUNDATION (NPI# 1508390287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508390287 |
| Entity Type | Organization |
| Organization Name | THE DEVEREUX FOUNDATION |
| Other Organization Name | DEVEREUX ADVANCED BEHAVIORAL HEALTH |
| Practice Address |
387 Ridge Street Newark NJ 07104 |
| Mailing Address |
286 Mantua Grove Road, Building #4 West Deptford NJ 08066 |
| Practice Telephone | 8565996400 |
| Practice Fax Number | 8565996404 |
| Mailing Telephone | 8565996400 |
| Mailing Fax Number | 8565996404 |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | MS. CAROLE CIRUCCI (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 8565996429 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | GH990 | NJ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0399507 | 05 |
| Other Name | Type Code |
|---|---|
| Devereux Advanced Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004568 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 407 Greentree Rd, Sewell, NJ 08080-9354 | 2020-05-14 |
| 1700425287 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 639 N South Turnpike Rd, Newfoundland, PA 18445-5032 | 2019-12-31 |
| 1346759867 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 233 Shaws Mill Rd, Cedarville, NJ 08311-2626 | 2017-09-27 |
| 1295261683 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 286 Mantua Grove Road, Building #4, West Deptford, NJ 08066 | 2017-05-04 |
| 1417482704 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 26 Aspen Hill, Deptford, NJ 08096 | 2017-04-25 |
| 1619402906 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 27 Aspen Hill, Deptford, NJ 08096 | 2017-04-25 |
| 1629503917 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 28 Aspen Hill, Deptford, NJ 08096 | 2017-04-25 |
| 1376078642 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 59 Boulevard, Elmwood Village Apartments, Elmwood Park, NJ 07407 | 2017-04-25 |
| 1730614017 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 48 Skyline Drive, Sparta, NJ 07871 | 2017-04-25 |
| 1326573601 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 103 Heritage Court, Pennington, NJ 08534 | 2017-04-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | THE DEVEREUX FOUNDATION | 444 Devereux Dr, Villanova, PA 19085 |
| New York State Corporations | THE DEVEREUX FOUNDATION | 302 Washington Avenue Ext., Suite 3, Albany, New York 12203 |
| Street Address |
387 RIDGE STREET |
| City | NEWARK |
| State | NJ |
| Zip Code | 07104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538790563 | North Ward Medical Arts LLC | Internal Medicine | 485-491 Mt Prospect Ave, Newark, NJ 07104 | 2020-01-29 |
| 1386149011 | Community Options Enterprises, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 504-506 Mount Prospect Ave, Newark, NJ 07104 | 2018-03-26 |
| 1710406293 | Bmrr Corporation | Durable Medical Equipment & Medical Supplies | 664 Mt Prospect Ave, Newark, NJ 07104 | 2017-09-15 |
| 1104280890 | North Essex Pediatrics Inc | Clinic/Center | 644 Mt Prospect Ave, Suite1, Newak, NJ 07104 | 2016-04-08 |
| 1306257076 | Sonia Martinez | Technician/Technologist | 677 Mount Prospect Avenue, Newark, NJ 07104 | 2014-05-15 |
| 1891022612 | Sofia Berkovich | Internal Medicine | 717-727 Broadway, Newark, NJ 07104 | 2009-11-16 |
| 1538302138 | Bellazmin Natalie Taylor | Physician Assistant | 354 Doremus Avenue, Newark, NJ 07104 | 2009-04-13 |
| 1740483502 | Clear Vision Optical, Inc. | Eyewear Supplier (Equipment, not the service) | 677 Mt Prospect Avenue, Newark, NJ 07104 | 2007-06-08 |
| 1083815146 | Rafael A Hernandez | Pharmacist | 794 Mt. Prospect Ave., Newark, NJ 07104 | 2007-05-29 |
| 1093934465 | Donald Dean-rusk Guerrier | Optometrist | 677 Mt. Prospect Ave, Newark, NJ 07104 | 2007-04-24 |
| Find all providers in zip 07104 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384204 | Devoted Homecare Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11 Coralberry Dr, Newark, DE 19702-3928 | 2020-10-26 |
| 1427683465 | Dyneise Tucker | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 87 2nd St Apt 2, Newark, NJ 07107-3103 | 2020-03-10 |
| 1720611478 | The North Ward Center, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 300 Clifton Ave, Newark, NJ 07104-1202 | 2020-02-20 |
| 1639700271 | Hope Jeka Kye | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 182 1st St, Newark, NJ 07107-2201 | 2020-02-02 |
| 1790337319 | Home 2 Care Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 515 Mount Prospect Ave Apt 1h, Newark, NJ 07104-2942 | 2019-07-13 |
| 1316420755 | The North Ward Center, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 346 Mount Prospect Ave, Newark, NJ 07104-2106 | 2018-09-12 |
| 1407333982 | Rasheeta Milton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24 Melrose Ave, Newark, NJ 07106-2708 | 2018-07-26 |
| 1386149011 | Community Options Enterprises, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 504-506 Mount Prospect Ave, Newark, NJ 07104 | 2018-03-26 |
| 1326550203 | Happy Home Nj, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 31 Midland Pl, Newark, NJ 07106-2803 | 2017-10-31 |
| 1528588258 | Arc of Essex County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 539 Mount Prospect Ave Apt 1, Newark, NJ 07104-1529 | 2017-06-23 |
| Find all providers in NEWARK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.