NPIMap

Organization Active NPI

Camelot Community Care, Inc

  • Foster Care Agency
  • Fort Lauderdale, FL
National Provider Identifier
1861064586
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
Legal business name
CAMELOT COMMUNITY CARE, INC
Practice address
1925 S Perimeter Rd Ste 120
Fort Lauderdale, FL 33309-7123
Phone
(954) 958-0988
Fax
(954) 958-3527
NPI assigned
Jul 13, 2021
Last updated
Jul 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Authorized official

Name
Jana Allen
Title
Director of Ar
Phone
(727) 593-0003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Foster Care Agency 253J00000X Primary

Addresses

Primary practice location

1925 S Perimeter Rd Ste 120
Fort Lauderdale, FL 33309-7123

Mailing address

4910 Creekside Dr Ste D
Clearwater, FL 33760-4034
Phone (727) 593-0003

Other identifiers 1

IdentifierTypeStateIssuer
070593400MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Camelot Community Care Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

4910 Creekside Dr
Ste D
Clearwater, FL 33760
Phone (727) 593-0003

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1861064586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 CREEKSIDE DR STE D",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337604034",
            "telephone_number": "727-593-0003",
            "fax_number": "727-595-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 S PERIMETER RD STE 120",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333097123",
            "telephone_number": "954-958-0988",
            "fax_number": "954-958-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT COMMUNITY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "DIRECTOR OF AR",
        "authorized_official_telephone_number": "727-593-0003"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070593400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.