Provider Demographics
NPI:1235212895
Name:THE DEVEREUX FOUNDATION
Entity type:Organization
Organization Name:THE DEVEREUX FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTRACTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-316-5433
Mailing Address - Street 1:1150 DEVEREUX DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2043
Mailing Address - Country:US
Mailing Address - Phone:281-335-1000
Mailing Address - Fax:281-554-7447
Practice Address - Street 1:1150 DEVEREUX DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:281-335-1000
Practice Address - Fax:281-554-7447
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE DEVEREUX FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-24
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
320600000X, 322D00000X, 322D00000X, 3245S0500X
TX511519323P00000X, 323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX511519OtherTEXAS DEPARTMENT OF HEALTH AND HUMAN SERVICES
TX511519OtherTEXAS DEPARTMENT OF HEALTH AND HUMAN SERVICES