Organization
CAMELOT HOME HEALTH AGENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CORINNE JOHNSON (CEO/COO)
(818) 363-5193
Entity
Organization
Contact information
Practice address
17715 CHATSWORTH AVENUE, SUITE 202, GRANADA HILLS, CA 91344-3285
(818) 363-5200
(866) 387-8690
Mailing address
17715 CHATSWORTH AVENUE, SUITE 202, GRANADA HILLS, CA 91344-3285
(818) 363-5200
(866) 387-8690
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
980001432
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA08204F
—
CA
Enumeration date
04/19/2006
Last updated
11/29/2012
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