| Camelot Care Centers, Llc. | |
|
34121 North Route 45 Suite 207 Grayslake IL 60030 | |
| (847) 993-9894 | |
| (847) 543-4534 |
| Full Name | Camelot Care Centers, Llc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 34121 North Route 45, Grayslake, Illinois |
| Authorized Official Name and Position | Ronica Patel (STATE EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6307731988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Camelot Care Centers, Llc. 333 W Pierce Rd Ste 175 Itasca IL 60143-3120 Ph: (847) 993-9894 | Camelot Care Centers, Llc. 34121 North Route 45 Suite 207 Grayslake IL 60030 Ph: (847) 993-9894 |
| NPI Number | 1700230976 |
|---|---|
| Provider Enumeration Date | 04/14/2016 |
| Last Update Date | 08/26/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700230976 | NPI | - | NPPES |
| 2B05-IPI-141 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 253J00000X | Foster Care Agency | (* (Not Available)) | Secondary |
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