Organization
CAMELOT CARE CENTERS, INC
Active
Parent organization
CAMELOT CARE CENTERS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAMELOT CARE CENTERS, INC
Authorized official
MR. JASON KEELER (STATE DIRECTOR)
(630) 773-1985
Entity
Organization
Contact information
Practice address
5901 N PROSPECT RD STE 101, PEORIA, IL 61614-4395
(309) 692-1095
(309) 692-1375
Mailing address
5901 N PROSPECT RD STE 101, PEORIA, IL 61614-4395
(309) 692-1095
(309) 692-1375
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05-IPI-141
—
IL
Enumeration date
12/21/2009
Last updated
12/21/2009
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