CAMELOT CARE CENTERS (NPI# 1912026261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912026261 |
| Entity Type | Organization |
| Organization Name | CAMELOT CARE CENTERS |
| Practice Address |
11711 Arbor St Ste 110 Omaha NE 68144-2975 |
| Mailing Address |
10304 Spotsylvania Ave Fl 3 Fredericksburg VA 22408-8602 |
| Practice Telephone | 4023922972 |
| Practice Fax Number | 4023922978 |
| Mailing Telephone | 5407102800 |
| Mailing Fax Number | 5407106447 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CHUCK BOIEN (STATE DIRECTOR) |
| Authorized Official Telephone | 6308605724 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 51069149 | NE | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700086725 | Camelot Care Centers | Community/Behavioral Health | 2991 Fort Henry Dr, Kingsport, TN 37664-4005 | 2007-07-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CAMELOT CARE CENTERS, INC. | 333 W Pierce Rd Ste 175, Itasca, IL 60143-3120 |
| Street Address |
11711 ARBOR ST STE 110 |
| City | OMAHA |
| State | NE |
| Zip Code | 68144-2975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720627292 | Jessica Wissink | Physical Therapist | 2275 South 132nd St, Omaha, NE 68144 | 2020-01-02 |
| 1881165397 | Elle Klink | Chiropractor | 2527 S 140th Street, Omaha, NE 68144 | 2018-12-10 |
| 1336649987 | Colton A Palmer | Nurse Practitioner | 11725 Arbor St Ste 230, Omaha, NE 68144 | 2018-02-20 |
| 1780121335 | Deborah Palmer | Massage Therapist | 2429 South 120th, Omaha, NE 68144 | 2017-01-20 |
| 1750833851 | Amanda Mcgary Tatro | Counselor | 11929 Elm St Suite 12a, Omaha, NE 68144 | 2016-10-25 |
| 1770946105 | Kindis Ward | Counselor | 13435 A. Street, Omaha, NE 68144 | 2016-04-02 |
| 1649679937 | Brian Douglas Smith | Physical Therapist | 13934 Gold Circle, Omaha, NE 68144 | 2014-08-22 |
| 1346587334 | Elite Professionals Home Care LLC | Home Health | 13306 A Street, Omaha, NE 68144 | 2013-01-10 |
| 1821345471 | Angelia D Henderson | Skilled Nursing Facility | 2525 S. 135th Ave, Omaha, NE 68144 | 2012-08-13 |
| 1073872123 | Midwest Physical Therapy Services, PC | Physical Therapist | 11640 Arbor Street #200, Omaha, NE 68144 | 2012-05-10 |
| Find all providers in zip 68144 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619534120 | Rejuvenating Women | Community Based Residential Treatment Facility, Mental Illness | 3507 Harney St, Omaha, NE 68131-3915 | 2019-05-21 |
| 1366772378 | Telecare Region 6 Recovery Center | Community Based Residential Treatment Facility, Mental Illness | 819 Dorcas St, Omaha, NE 68108-1137 | 2010-01-14 |
| 1609095306 | Behaven Day Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 8922 Cuming St, Omaha, NE 68114-2732 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396963930 | Life Quest Inc. | Community Based Residential Treatment Facility, Mental Illness | 201 Commercial, Palmer, NE 68864-0217 | 2007-04-20 |
| 1063578508 | Centerpointe, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2220 S 10th St, Lincoln, NE 68502-3445 | 2006-12-29 |
| 1700941879 | Centerpointe, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2633 P St, Lincoln, NE 68503-3528 | 2006-12-27 |
| 1063590982 | I Believe In Me Ranch, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2041 E 56th St, Kearney, NE 68847-4179 | 2006-11-01 |
| 1639615198 | The Link Dual Recovery Program | Community Based Residential Treatment Facility, Mental Illness | 305 N 9th St, Norfolk, NE 68701-3915 | 2017-01-09 |
| 1225407422 | Centerpointe, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2039 Q St, 2, Lincoln, NE 68503-3643 | 2015-09-17 |
| 1134421696 | The Communitysupports Network | Community Based Residential Treatment Facility, Mental Illness | 5701 Thompson Creek Blvd, Suite 200, Lincoln, NE 68516-5662 | 2010-12-03 |
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| 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.