Organization
CAMELOT REALTY LLC
Active
Other names
Camelot Chateau
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY L RUSSELL (MANAGER)
(727) 489-0857
Entity
Organization
Contact information
Practice address
1831 SE LAKE WEIR AVE, OCALA, FL 34471-5412
(352) 629-6077
(352) 629-3792
Mailing address
3600 OAK MANOR LN, LARGO, FL 33774-1212
(727) 489-0857
(727) 489-3334
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL5429
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14396601
—
FL
Enumeration date
05/15/2008
Last updated
05/15/2008
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