| Camelot Community Care, Inc | |
|
5569 Broadcast Ct Lakewood Ranch FL 34240-8472 | |
| (941) 254-4900 | |
| Not Available |
| Full Name | Camelot Community Care, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5569 Broadcast Ct, Lakewood Ranch, Florida |
| Authorized Official Name and Position | Jana Allen (DIRECTOR OF AR) |
| Authorized Official Contact | 7275930003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Camelot Community Care, Inc 4910 Creekside Dr Ste D Clearwater FL 33760-4034 Ph: (727) 593-0003 | Camelot Community Care, Inc 5569 Broadcast Ct Lakewood Ranch FL 34240-8472 Ph: (941) 254-4900 |
| NPI Number | 1023786993 |
|---|---|
| Provider Enumeration Date | 09/03/2021 |
| Last Update Date | 09/03/2021 |
| Certification Date | 08/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023786993 | NPI | - | NPPES |
| 070673604 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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