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Organization
CAMELOT CARE CENTERS, LLC
Active
Organization
CAMELOT CARE CENTERS, LLC
Active
Parent organization
PATHWAYS HEALTH AND COMMUNITY SUPPORT, LLC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PATHWAYS HEALTH AND COMMUNITY SUPPORT, LLC.
Authorized official
MRS. RONICA PATEL (STATE EXECUTIVE DIRECTOR)
(630) 773-1985
Entity
Organization
Contact information
Practice address
2396 W NEBRASKA AVE, PEORIA, IL 61604-3111
(309) 676-6305
(309) 676-6519
Mailing address
2396 W NEBRASKA AVE, PEORIA, IL 61604-3111
(309) 676-6305
(309) 676-6519
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05-IPI-141
—
IL
Enumeration date
06/21/2012
Last updated
06/04/2020
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