Organization
CAMELOT OF VIRGINIA, LLC
Active
Other names
Roanoke Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
GRAYSON HARCOURT (BUSINESS OFFICE DIRECTOR)
(512) 858-9900
Entity
Organization
Contact information
Practice address
1729 PATTERSON AVE SW, ROANOKE, VA 24016-3105
(540) 345-4533
Mailing address
4207 E HIGHWAY 290, DRIPPING SPRINGS, TX 78620-4206
(512) 858-9900
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/18/2007
Last updated
09/18/2007
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