DEVEREUX FOUNDATION WHITLOCK


Address: 121 Leopard Rd, Berwyn, PA 19312-1809
Phone: 6102966800

DEVEREUX FOUNDATION WHITLOCK (NPI# 1609908375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609908375
Entity Type Organization
Organization Name DEVEREUX FOUNDATION WHITLOCK
Other Organization Name WHITLOCK VOCATIONAL SERVICES
Practice Address 121 Leopard Rd
Berwyn
PA 19312-1809
Mailing Address 2012 Renaissance Blvd
King of Prussia
PA 19406-2786
Practice Telephone 6102966800
Practice Fax Number 6102512013
Mailing Telephone 6105423084
Mailing Fax Number 6105423191
Enumeration Date 2007-03-09
Last Update Date 2020-08-22
Authorized Official Name FRAN WAGNER (NATIONAL DIRECTOR, ACCTS RECEIVABLE)
Authorized Official Telephone 6105423084
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QD1600X Clinic/Center
Specialization: Developmental Disabilities
123180 PA Ambulatory Health Care Facilities
Y 261QD1600X Clinic/Center
Specialization: Developmental Disabilities
104270 PA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
PA 100001913-0268 05
PA 100001913-0242 05

Other Provider/Organization Names

Other Name Type Code
Whitlock Vocational Services Other Name - Individual/Organization

Office Location

Street Address 121 LEOPARD RD
City BERWYN
State PA
Zip Code 19312-1809

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1124440730 Sofie Heyman Marriage & Family Therapist 1034 Beaumont Rd, Berwyn, PA 19312 2014-01-16
1437303880 Megan O'keefe Occupational Therapist 622 First Ave., Berwyn, PA 19312 2008-11-12
1235383084 Working Together Inc. Naturopath 411 E. Lancaster Ave., Wayne, PA 19312 2008-11-06
1750559050 Kenneth Kondracki Pharmacist 450 Mw Swedesford Rd, Berwyn, PA 19312 2008-02-20
1962624312 John B Fitzgerald IIi Dentist 1201 W Swedesford Road, Berwyn, PA 19312 2007-05-03
1760607576 Kathleen Jane Ramsdell Occupational Therapist 2 Harrow Lane, Berwyn, PA 19312 2007-04-16
1679604979 Matthew Lewullis Family Medicine 1001 Chesterbrook Boulevard, Berwyn, PA 19312 2007-03-08
1962550996 Christine Marie Specht Registered Nurse 1199 Lancaster Avenue, Suite 106, Berwyn, PA 19312 2007-01-08
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Taxonomy Information

Taxonomy Code 261QD1600X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Developmental Disabilities

Taxonomy Definition

An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
Notes: [7/1/2003: new]

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Competitor

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City BERWYN
Zip Code 19312

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Dataset Information

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.

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