OrganizationActive
Devereux Foundation Country Club
NPI 1104949163 · Intellectual Disabilities Intermediate Care Facility · Phoenixville, PA
Provider details
- NPI number
- 1104949163
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Fran Wagner, National Accts Receivable Director(610) 542-3084
- License
- 504640 (PA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
755 Country Club Rd
Phoenixville, PA 19460-2725
Phone: (610) 296-6800
Fax: (610) 251-2013
Approximate (ZIP-level) locationGet directions
Mailing address
2012 Renaissance Blvd
King of Prussia, PA 19406-2786
Other names (DBA / former)
- Other name
- Whitlock Country Club
Registry dates
- Enumerated
- 2007-04-06
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.