Camelot Home Health Agency, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

980001432 Issued in CA

Legal business name

CAMELOT HOME HEALTH AGENCY, INC.

Practice address

17715 Chatsworth Avenue
Suite 202
Granada Hills, CA 91344-3285

Phone

(818) 363-5200

Fax

(866) 387-8690

NPI assigned

Apr 19, 2006

Last updated

Nov 29, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Corinne Johnson

Title

Ceo/Coo

Phone

(818) 363-5193

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1194780551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17715 CHATSWORTH AVENUE",
            "address_2": "SUITE 202",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913443285",
            "telephone_number": "818-363-5200",
            "fax_number": "866-387-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17715 CHATSWORTH AVENUE",
            "address_2": "SUITE 202",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913443285",
            "telephone_number": "818-363-5200",
            "fax_number": "866-387-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT HOME HEALTH AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CORINNE",
        "authorized_official_title_or_position": "CEO/COO",
        "authorized_official_telephone_number": "818-363-5193",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08204F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.