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WHITLOCK COUNTRY CLUB
NPI 1104949163
Intermediate Care Facility, Intellectual Disabilities in Phoenixville, PA

Active since April 06, 2007
755 COUNTRY CLUB RD, PHOENIXVILLE, PA 19460(610) 296-6800(610) 251-2013 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Whitlock Country Club NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WHITLOCK COUNTRY CLUB (NPI 1104949163) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Phoenixville, Pennsylvania and active in the NPI registry since April 2007. The organization lists Fran Wagner, National Accts Receivable Director, as its authorized official.

NPPES Registry Identity

NPI1104949163
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameDEVEREUX FOUNDATION COUNTRY CLUB
Location Address755 COUNTRY CLUB RDPhoenixville, PA 19460-2725
Mailing Address2012 Renaissance BlvdKing Of Prussia, PA 19406-2786 · (610) 542-3084 · Fax (610) 542-3191
Phone(610) 296-6800
Fax(610) 251-2013
Organization SubpartNo
Authorized OfficialFran WagnerNational Accts Receivable Director · (610) 542-3084
Enumeration DateApril 6, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1104949163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License✔ Licensed in PA · 504640
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
755 COUNTRY CLUB RD, Phoenixville, PA 19460
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Other Names 1

Other NameWhitlock Country Club

Other Identifiers 1

Medicaid1000019130308PA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Devereux Foundation Country Club's NPI number?

The NPI number for Devereux Foundation Country Club is 1104949163. It was assigned to this organization in the NPPES registry on April 6, 2007. The provider is also known as Whitlock Country Club.

Where is Devereux Foundation Country Club located?

Devereux Foundation Country Club is located at 755 Country Club Rd, Phoenixville, PA 19460. The listed phone number is (610) 296-6800.

What is Devereux Foundation Country Club's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Devereux Foundation Country Club was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.