DEVEREUX FOUNDATION (NPI# 1609958628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609958628 |
| Entity Type | Organization |
| Organization Name | DEVEREUX FOUNDATION |
| Other Organization Name | DEVEREUX TEXAS TREATMENT NETWORK |
| Practice Address |
120 David Wade Drive Victoria TX 77905 |
| Mailing Address |
Po Box 2666 Victoria TX 77902-2666 |
| Practice Telephone | 3615758271 |
| Practice Fax Number | 3615756520 |
| Mailing Telephone | 3615758271 |
| Mailing Fax Number | 3615756520 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2009-07-14 |
| Authorized Official Name | MS. PAMELA E. HELM (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2813351000 |
| Is Organization Subpart | Y |
| Parent Organization Name | DEVEREUX FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5460 | TX | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 112748201 | 05 | |
| TX | 112748202 | 05 |
| Other Name | Type Code |
|---|---|
| Devereux Texas Treatment Network | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952908618 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 604 Glen Circle Dr, Tobyhanna, PA 18466-8300 | 2020-10-06 |
| 1356969679 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 100 Genuardi Circle, West Chester, PA 19380 | 2020-07-13 |
| 1447882618 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 147 W Academy St, Clayton, NJ 08312-1435 | 2020-02-06 |
| 1043866858 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 124 Wertsville Rd Bldg 2, Hillsborough, NJ 08844-3908 | 2019-08-16 |
| 1205494978 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 240 Longhouse Dr Bldg B, Hewitt, NJ 07421-3730 | 2019-05-29 |
| 1023675808 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 440 Fislerville Rd, South Harrison Township, NJ 08062-4435 | 2019-05-28 |
| 1346700010 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 780 Watchung Rd, Bound Brook, NJ 08805-1455 | 2019-03-20 |
| 1609333194 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 34 Creek Ln, Mount Royal, NJ 08061-1039 | 2019-02-21 |
| 1902370570 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 122 Leopard Rd, Berwyn, PA 19312-1809 | 2019-01-17 |
| 1326512476 | Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 109 Bloss Rd, Canadensis, PA 18325-4741 | 2019-01-11 |
| Street Address |
120 DAVID WADE DRIVE |
| City | VICTORIA |
| State | TX |
| Zip Code | 77905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447819958 | Amber Fay Kotzur | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2019-06-08 |
| 1053603712 | Scarlett Black | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2011-05-12 |
| 1447572953 | Angelle T Solano | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2010-02-25 |
| 1841528114 | Kimberly W Modisette | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2009-11-25 |
| 1821232117 | Alyce Yvonne Martin | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2009-04-30 |
| 1073781712 | Elizabeth Edith Stolte | Counselor | 120 David Wade Drive, Victoria, TX 77905 | 2008-02-15 |
| 1740407386 | Darlyn R Sustaita | Counselor | 120 David Wade Drive, Victoria, TX 77902-2666 | 2007-04-18 |
| 1982821534 | Jill E Latonick-flores | Counselor | 120 David Wade Drive, Victoria, TX 77902-2666 | 2007-04-18 |
| 1215153838 | Sarah D Sims | Counselor | 120 David Wade Drive, Victoria, TX 77902-2666 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467920116 | Cameo Lynn Mead | Counselor | 513 Dove Dr, Victoria, TX 77905 | 2018-11-09 |
| 1952883308 | Danielle Renee Rainosek | Registered Nurse | 2058 Berger Road, Victoria, TN 77905 | 2018-09-02 |
| 1487130175 | Stephanie Reichert-garza | Licensed Vocational Nurse | 135 Tilley Ln, Victoria, TX 77905 | 2018-07-16 |
| 1417281858 | Debbie A Coltman | Counselor | 120 David Wade Dr, Victoria, TX 77905 | 2009-10-01 |
| 1780186940 | Brooke Salazar | Registered Nurse | 304 Royal Oak St, Victoria, TX 77905-0625 | 2018-03-05 |
| 1336524974 | Adan Hinojosa Adame | Nurse Practitioner | 102 Contento St, Victoria, TX 77905-0688 | 2015-07-24 |
| 1528568383 | Betty Sue Stafford | Licensed Vocational Nurse | 488 Old Bloomington Rd N, Victoria, TX 77905-2118 | 2018-02-19 |
| 1700387008 | Sayra Joyce Borden | Licensed Vocational Nurse | 376 Old Bloomington Rd N, Victoria, TX 77905-2122 | 2018-02-22 |
| 1306478177 | Elizabeth Thompson | Licensed Vocational Nurse | 456 Price Rd, Victoria, TX 77905-2522 | 2020-02-10 |
| 1235610791 | Brenda Ann Kelsey | Registered Nurse | 103 Forest View Dr, Victoria, TX 77905-2565 | 2018-08-23 |
| Find all providers in zip 77905 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295295160 | Supportive Family Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2189 K V Rd, Victoria, VA 23974-2538 | 2019-03-25 |
| 1437189487 | Gulf Bend Mhmr Center Icf/mr | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 902 Bellevue St, Victoria, TX 77904-1424 | 2006-07-04 |
| 1649200684 | Gulf Bend Mrmr Center Icf/mr | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 306 Edinburgh St, Victoria, TX 77904-2864 | 2006-07-04 |
| 1992735955 | Gulf Bend Mrmr Center Icf/mr | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2006 N Wheeler St, Victoria, TX 77901-4849 | 2006-07-04 |
| 1124489364 | Ucg Central Texas Holdings, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 306 Edinburgh St, Victoria, TX 77904-2864 | 2016-03-16 |
| 1033579651 | Ucg Central Texas Holdings, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2006 N Wheeler St, Victoria, TX 77901-4849 | 2016-02-24 |
| 1245690866 | Ucg Central Texas Holdings, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 902 Bellevue St, Victoria, TX 77904-1424 | 2016-02-24 |
| 1952336398 | Gulf Bend Mhmr Center Txhml Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1502 E Airline Rd, Suite 25, Victoria, TX 77901-4112 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619581782 | Joyful Psalm | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1354 Ravenwood Ct, Crowley, TX 76036-3472 | 2020-09-04 |
| 1790394161 | Modern Vintage Residential Care, LLC. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4015 Alexis Tate Cir, Missouri City, TX 77459-5039 | 2020-07-30 |
| 1285253856 | 1 Care Premier Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 340 N Sam Houston Pkwy E Ste A247, Houston, TX 77060-3305 | 2020-04-13 |
| 1568093888 | James Micah Howard | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11911 Lakewood Trl, Tomball, TX 77377-8563 | 2020-01-27 |
| 1518507110 | Gems Residence LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5810 Liverpool St, Aubrey, TX 76227-1909 | 2020-01-10 |
| 1366081812 | Abundant Care Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1100 Maxfield St, Waco, TX 76705-2967 | 2020-01-02 |
| 1306487426 | Fort Healthcare LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5833 Oakbend Trail, #200, Fort Worth, TX 76132-3900 | 2019-09-30 |
| 1144877481 | Boniswa Portia Maduna | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8000 Cook Rd Apt 1109, Houston, TX 77072-3939 | 2019-08-21 |
| 1871148171 | Kenneth Allen | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 135 E Menefee St, Lufkin, TX 75901-4701 | 2019-08-05 |
| 1124673553 | 1st A & M Healthcare Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 504 Spicewood Dr, Desoto, TX 75115-1485 | 2019-08-02 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DEVEREUX FOUNDATION.
| 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.