Organization · Type 2 NPI
Devereux Foundation Country Club
Intellectual Disabilities Intermediate Care Facility · Phoenixville, PA
NPI number
1104949163
Active
Practice location
755 Country Club Rd
Phoenixville, PA 19460-2725
Fax (610) 251-2013
Mailing address
2012 Renaissance Blvd
King Of Prussia, PA 19406-2786
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 504640 (PA) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1104949163
Devereux Foundation Country Club's National Provider Identifier is 1104949163, issued on Apr 6, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Phoenixville, PA. The record was last updated on Aug 22, 2020.