CAMELOT CARE CENTERS, LLC (NPI# 1538767090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538767090 |
| Entity Type | Organization |
| Organization Name | CAMELOT CARE CENTERS, LLC |
| Practice Address |
2144 S Macarthur Blvd Springfield IL 62704-4502 |
| Mailing Address |
333 W Pierce Rd Ste 175 Itasca IL 60143-3120 |
| Practice Telephone | 2175259185 |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |
| Authorized Official Name | RONICA R PATEL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8478497664 |
| Is Organization Subpart | Y |
| Parent Organization Name | PATHWAYS AND COMMUNITY SUPPORT, LLC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891393781 | Camelot Care Centers, LLC | Clinic/Center | 34121 North Route 45 Suite 207, Grayslake, IL 60030 | 2020-10-13 |
| 1831797141 | Camelot Care Centers, LLC | Clinic/Center | 5301 E State St Ste 208, Rockford, IL 61108-2397 | 2020-10-09 |
| 1740510338 | Camelot Care Centers, LLC | Community/Behavioral Health | 2144 S Macarthur Blvd, Springfield, IL 62704-4502 | 2010-01-05 |
| 1710217336 | Camelot Care Centers, LLC | Community/Behavioral Health | 4747 Lincoln Mall Dr Ste 305, Matteson, IL 60443-3814 | 2010-01-04 |
| 1093957300 | Camelot Care Centers, LLC | Community/Behavioral Health | 333 W Pierce Rd, Suite 175, Itasca, IL 60143-3116 | 2009-04-01 |
| 1215535786 | Camelot Care Centers, LLC | Clinic/Center | 2396 W Nebraska Ave, Peoria, IL 61604-3111 | 2020-10-15 |
| 1093313553 | Camelot Care Centers, LLC | Clinic/Center | 333 W Pierce Rd Ste 175, Itasca, IL 60143-3120 | 2020-10-15 |
| 1740888205 | Camelot Care Centers, LLC | Clinic/Center | 4747 Lincoln Mall Dr Ste 305, Matteson, IL 60443-3814 | 2020-10-15 |
| 1700149051 | Camelot Care Centers, LLC | Community/Behavioral Health | 2396 W Nebraska Ave, Peoria, IL 61604-3111 | 2012-06-21 |
| Street Address |
2144 S MACARTHUR BLVD |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740510338 | Camelot Care Centers, LLC | Community/Behavioral Health | 2144 S Macarthur Blvd, Springfield, IL 62704-4502 | 2010-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
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| 1851860209 | Preferred Family Healthcare, Inc | Clinic/Center | 3300 S National Ave Ste 500, Springfield, MO 65807-7343 | 2018-11-15 |
| 1982129722 | Solid Ground Counseling Services, LLC | Clinic/Center | 2515 W Allen Dr, Springfield, MO 65810-1300 | 2017-08-12 |
| 1568814390 | Self | Clinic/Center | 19 Merrick Ave Apt 1, Springfield, MA 01109-4324 | 2016-07-05 |
| 1609483049 | G Street Integrated Health | Clinic/Center | 1435 G St, Springfield, OR 97477-4113 | 2020-09-29 |
| 1225463136 | Colby Wang, Md, LLC | Clinic/Center | 636 W Republic Rd, B-112, Springfield, MO 65807-5818 | 2013-09-10 |
| 1174868442 | Ct- Family Care Services, LLC | Clinic/Center | 155 Maple St, Unit 204, Springfield, MA 01105-2649 | 2012-11-28 |
| 1922253947 | The Children's Center - Medical Services | Clinic/Center | 5220 S 6th Street Rd, Suite 2200, Springfield, IL 62703-5735 | 2008-11-18 |
| 1457505125 | Mental Health Centers of Central Illinois | Clinic/Center | 5220 S 6th Street Rd, Suite 2400, Springfield, IL 62703-5735 | 2008-11-07 |
| 1073706602 | Zoe Alison Burch | Clinic/Center | 15 E Pleasant St, Springfield, OH 45506-2201 | 2007-08-27 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
Please comment or provide details below to improve the information on CAMELOT CARE CENTERS, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.