Camellia House LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

2991 Issued in VA

Legal business name

CAMELLIA HOUSE LLC

Practice address

8027 Camellia Rd
Norfolk, VA 23518-3416

Phone

(757) 227-1105

NPI assigned

Aug 25, 2016

Organization subpart

No

Name

Ephaim Cruz

Title

President/Ceo

Phone

(757) 227-1105

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ephraim Cruz

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Norfolk, VA
  • NPI 1811508252
  NPD COMMUNITY BASED RESIDENTIAL TREATMENT FACILITY, INTELLECTUAL AND/OR DEVELOPMENTAL DISABILITIES

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 15, 2020.

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1164978656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8027 CAMELLIA RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235183416",
            "telephone_number": "757-227-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8027 CAMELLIA RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235183416",
            "telephone_number": "757-227-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELLIA HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-25",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "EPHAIM",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "757-227-1105"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "2991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William E. Callaghan, M.D.
• Linda Brede Callahan, RN, IBCLC
• Roscoe Callaway, CONTRACTOR
• Milana-Thai Caira Calupitan
• Stephanie Nora Camacho, NNP-BC
• Jessica Cameron
• Robert Michael Camp, MD
• Campbell House Inc
• Brian David Campbell, USN-IDC
• Brianna Leigh Campbell, CSA

• All providers in Norfolk, VA
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.