Camelot Brookside LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

CAMELOT BROOKSIDE LLC

Doing business as

Camelot Brookside

Practice address

3330 N Frontage Rd
Jennings, LA 70546-3269

Phone

(337) 824-2466

NPI assigned

Dec 14, 2011

Last updated

Dec 14, 2011By 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

Nicole Howard

Title

C.O.O.

Phone

(318) 445-6470

Specialties & licenses 2

Addresses

Other names 1

• Camelot Brookside Doing business as

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323820800000",
    "number": "1689943078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713603828",
            "telephone_number": "318-445-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 N FRONTAGE RD",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463269",
            "telephone_number": "337-824-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT BROOKSIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "318-445-6470"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelot Brookside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Facility/Intermediate Care Facility in Jennings, LA
• Providers in Jennings, LA by specialty
• Nursing Facility/Intermediate Care Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.