| Camelot Care Centers, Llc | |
|
5301 E State St Ste 208 Rockford IL 61108-2397 | |
| (815) 484-9180 | |
| Not Available |
| Full Name | Camelot Care Centers, Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 5301 E State St Ste 208, Rockford, Illinois |
| Authorized Official Name and Position | Ronica R Patel (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6307731985 |
| 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: () - | Camelot Care Centers, Llc 5301 E State St Ste 208 Rockford IL 61108-2397 Ph: (815) 484-9180 |
| NPI Number | 1831797141 |
|---|---|
| Provider Enumeration Date | 10/09/2020 |
| Last Update Date | 10/18/2021 |
| Certification Date | 10/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831797141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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