NPIMap

Organization Active NPI

Camelot of Virginia, LLC

Doing business as Tekoa 1

  • Mental Illness Community Based Residential Treatment Facility
  • Pilot, VA
National Provider Identifier
1245426428
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
CAMELOT OF VIRGINIA, LLC
Doing business as
Tekoa 1
Practice address
4410 Christiansburg Pike
Pilot, VA 24138
Phone
(540) 745-3887
NPI assigned
Sep 20, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Grayson Harcourt
Title
Business Office Director
Phone
(512) 858-9900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

4410 Christiansburg Pike
Pilot, VA 24138

Mailing address

4207 E Highway 290
Dripping Springs, TX 78620-4206

Other names 1

  • Tekoa 1 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Camelot of Virginia LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

4207 E Highway 290
Dripping Springs, TX 78620
Phone (512) 858-9900

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1245426428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 E HIGHWAY 290",
            "city": "DRIPPING SPRINGS",
            "state": "TX",
            "postal_code": "786204206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 CHRISTIANSBURG PIKE",
            "city": "PILOT",
            "state": "VA",
            "postal_code": "24138",
            "telephone_number": "540-745-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT OF VIRGINIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "HARCOURT",
        "authorized_official_first_name": "GRAYSON",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "512-858-9900"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tekoa 1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pilot, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.