Organization
CAMELOT COMMUNITY CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA ALLEN (DIRECTOR OF AR)
(727) 593-0003
Entity
Organization
Contact information
Practice address
1410 TECH BLVD, TAMPA, FL 33619-7865
(813) 635-9765
(813) 635-9725
Mailing address
4910 CREEKSIDE DR STE D, CLEARWATER, FL 33760-4034
(727) 593-0003
(727) 595-0735
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
MH 7500
FL
251S00000X
Community/Behavioral Health Agency
—
—
253J00000X
Foster Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070590000
—
FL
Enumeration date
11/05/2009
Last updated
07/13/2021
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