CAMELLIA PLACE HEALTHCARE SERVICES LLC


Address: 100 Market Sq Ste 12, Newington, CT 06111-2921
Phone: 8603221011

CAMELLIA PLACE HEALTHCARE SERVICES LLC (NPI# 1447812250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1447812250
Entity Type Organization
Organization Name CAMELLIA PLACE HEALTHCARE SERVICES LLC
Practice Address 100 Market Sq Ste 12
Newington
CT 06111-2921
Mailing Address 24 Sachem Cir
Meriden
CT 06450-7403
Practice Telephone 8603221011
Mailing Telephone 2037151319
Enumeration Date 2019-07-01
Last Update Date 2019-09-06
Authorized Official Name DR. CAMILLE A PAYNE (NURSE PRACTITIONER)
Authorized Official Telephone 8603221011
Authorized Official Credential MPH, APRN, DNP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM0850X Clinic/Center
Specialization: Adult Mental Health
Ambulatory Health Care Facilities
N 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
Ambulatory Health Care Facilities
N 363LF0000X Nurse Practitioner
Specialization: Family
Physician Assistants & Advanced Practice Nursing Providers
N 363LP2300X Nurse Practitioner
Specialization: Primary Care
Physician Assistants & Advanced Practice Nursing Providers
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Office Location

Street Address 100 MARKET SQ STE 12
City NEWINGTON
State CT
Zip Code 06111-2921

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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City NEWINGTON
Zip Code 06111

Improve Information

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Dataset Information

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.

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