Organization
CAMELLIA PLACE HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAMILLE A PAYNE MPH, APRN, DNP (NURSE PRACTITIONER)
(860) 322-1011
Entity
Organization
Contact information
Practice address
100 MARKET SQ STE 12, NEWINGTON, CT 06111-2921
(860) 322-1011
Mailing address
24 SACHEM CIR, MERIDEN, CT 06450-7403
(203) 715-1319
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
07/01/2019
Last updated
09/06/2019
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