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 R PATEL (STATE EXECUTIVE DIRECTOR)
(630) 773-1985
Entity
Organization
Contact information
Practice address
333 W PIERCE RD, SUITE 175, ITASCA, IL 60143-3116
(630) 773-1985
(630) 773-1988
Mailing address
333 W PIERCE RD, SUITE 175, ITASCA, IL 60143-3116
(630) 773-1985
(630) 773-1988
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
04/01/2009
Last updated
06/04/2020
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