Organization
CAMELOT CARE CENTERS, LLC
Active
Parent organization
PATHWAYS HEALTH AND SUPPORT SERVICES, LLC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PATHWAYS HEALTH AND SUPPORT SERVICES, LLC.
Authorized official
RONICA R PATEL (STATE EXECUTIVE DIRECTOR)
(630) 773-1985
Entity
Organization
Contact information
Practice address
2144 S MACARTHUR BLVD, SPRINGFIELD, IL 62704-4502
(217) 585-9185
(217) 585-8522
Mailing address
333 W PIERCE RD STE 175, ITASCA, IL 60143-3120
(217) 585-9185
(217) 585-8522
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05-IPI-141
—
IL
Enumeration date
01/05/2010
Last updated
10/18/2021
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