Devereux Cleo Wallace
NPI #1184723660 in Westminster, Colorado
Provider Information
- NPI Number
- 1184723660
- Entity Type
- Organization
- Organization Name
- Devereux Cleo Wallace
- Primary Specialty
- Residential Treatment Facility, Emotionally Disturbed Children
- Enumeration Date
- Sep 21, 2006
- Last Updated
- Mar 11, 2022
Practice Location
- Address
- 8405 CHURCH RANCH BLVD
- City
- Westminster
- State
- Colorado
- ZIP Code
- 80021-3918
- Phone
- (303) 466-7391
Authorized Official
- Name
- BONNIE WRIGHT
- Title
- QUALITY IMPROVEMENT DIRECTOR
- Phone
- (303) 438-2265
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatric Residential Treatment Facility |
| Residential Treatment Facility, Emotionally Disturbed Children |
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