Organization
SEQUEL SCHOOLS LLC DBA KINGSTON ACADEMY
Active
Other names
Camelot of Tennessee
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL LEE HEMBREE BA (EXECUTIVE DIRECTOR)
(865) 376-2296
Entity
Organization
Contact information
Practice address
183 FIDDLER'S LANE, KINGSTON, TN 37763-4020
(865) 376-2296
(865) 376-0369
Mailing address
1131 EAGLETREE LANE, HUNTSVILLE, AL 35801-6478
(256) 880-3339
(256) 880-7026
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
L 2(37)M3-016-1155
TN
323P00000X
Psychiatric Residential Treatment Facility
Primary
L000000008435
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1440370
—
TN
05
—
3810000021
—
WV
Enumeration date
12/05/2006
Last updated
09/08/2011
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