| Camelot Care Centers, Llc | |
|
817 W Pioneer Pkwy Peoria IL 61615-2144 | |
| (309) 676-6305 | |
| Not Available |
| Full Name | Camelot Care Centers, Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 817 W Pioneer Pkwy, Peoria, Illinois |
| Authorized Official Name and Position | Ronica R Patel (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6307731985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Camelot Care Centers, Llc 333 W Pierce Rd Ste 175 Itasca IL 60143-3120 Ph: () - | Camelot Care Centers, Llc 817 W Pioneer Pkwy Peoria IL 61615-2144 Ph: (309) 676-6305 |
| NPI Number | 1215535786 |
|---|---|
| Provider Enumeration Date | 10/15/2020 |
| Last Update Date | 04/03/2024 |
| Certification Date | 04/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215535786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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