A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Residential Treatment Facility, Emotionally Disturbed Children | 322D00000X |
| Psychiatric Residential Treatment Facility | 323P00000X |
* Indicates primary specialty
| NPI Number | 1184723660 |
| Legal business name LBN |
DEVEREUX CLEO WALLACE |
| Authorized official | BONNIE WRIGHT - (QUALITY IMPROVEMENT DIRECTOR) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 09/21/2006 |
| Last updated | 03/11/2022 - About 4 years ago |
| Sole proprietor1 | Not specified |
| Identifiers |
|
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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