NPIMap

Organization Active NPI

Camelot Care Centers

  • Mental Illness Community Based Residential Treatment Facility
  • Omaha, NE
National Provider Identifier
1912026261
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
51069149 Issued in NE
Legal business name
CAMELOT CARE CENTERS
Practice address
11711 Arbor St Ste 110
Omaha, NE 68144-2975
Phone
(402) 392-2972
Fax
(402) 392-2978
NPI assigned
Mar 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Chuck Boien
Title
State Director
Phone
(630) 860-5724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 51069149 NE Primary

Addresses

Primary practice location

11711 Arbor St Ste 110
Omaha, NE 68144-2975

Mailing address

10304 Spotsylvania Ave FL 3
Fredericksburg, VA 22408-8602
Phone (540) 710-2800

National Provider Directory

National Provider Directory
Tax ID family
Camelot Care Services21 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

11711 Arbor St
Ste 110
Omaha, NE 68144
Phone (402) 392-2972

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912026261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10304 SPOTSYLVANIA AVE FL 3",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224088602",
            "telephone_number": "540-710-2800",
            "fax_number": "540-710-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 ARBOR ST STE 110",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442975",
            "telephone_number": "402-392-2972",
            "fax_number": "402-392-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT CARE CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOIEN",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "STATE DIRECTOR",
        "authorized_official_telephone_number": "630-860-5724",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NE",
            "license": "51069149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.