Organization
CAMELOT BROOKSIDE LLC
Active
Other names
Camelot Brookside
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE HOWARD (C.O.O.)
(318) 445-6470
Entity
Organization
Contact information
Practice address
3330 N FRONTAGE RD, JENNINGS, LA 70546-3269
(337) 824-2466
Mailing address
4333 SHREVEPORT HWY, PINEVILLE, LA 71360-3828
(318) 445-6470
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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