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
RONICA PATEL (STATE EXECUTIVE DIRECTOR)
(630) 773-1985
Entity
Organization
Contact information
Practice address
5301 E STATE ST, SUITE 208, ROCKFORD, IL 61108-2901
(815) 484-9180
(815) 484-9183
Mailing address
5301 E STATE ST, SUITE 208, ROCKFORD, IL 61108-2901
(815) 484-9180
(815) 484-9183
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05-IPI-141
—
IL
Enumeration date
01/14/2010
Last updated
08/27/2019
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