Camelot Care Centers, LLC

Organization Active NPI Adolescent and Children Mental Health Clinic/Center · Peoria, IL

NPI 1215535786 · NPPES record last updated Apr 3, 2024

Key facts

NPI
1215535786
Entity type
Organization (NPI type 2)
Primary specialty
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Legal business name
CAMELOT CARE CENTERS, LLC
Practice address
817 W Pioneer Pkwy
Peoria, IL 61615-2144
Phone
(309) 676-6305
NPI assigned
Oct 15, 2020
Organization subpart
Yes
Parent organization (as reported)
PATHWAYS HEALTH AND COMMUNITY SUPPORT, LLC.

Authorized official

Name
Ronica R Patel
Title
Executive Director
Phone
(630) 773-1985

Corporate family (same tax ID) 19

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 5

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

National Provider Directory

Tax ID family
Camelot Care Centers in (20 organizations share this tax ID)
Part of
Camelot Care Centers LLC

Locations

817 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 676-6305

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Yes

Addresses

Primary practice location

817 W Pioneer Pkwy
Peoria, IL 61615-2144

Mailing address

333 W Pierce Rd Ste 175
Itasca, IL 60143-3120

Other providers in Peoria, IL

All providers in Peoria, IL · Adolescent and Children Mental Health Clinic/Center in Illinois

Sources for this page

Verify at the official NPI Registry.