Provider Demographics
NPI:1548469570
Name:CAMELOT CARE CENTERS, INC
Entity type:Organization
Organization Name:CAMELOT CARE CENTERS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:VEALE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:615-370-4228
Mailing Address - Street 1:5100 POPLAR AVE
Mailing Address - Street 2:SUITE 2805
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38137-4000
Mailing Address - Country:US
Mailing Address - Phone:901-821-0311
Mailing Address - Fax:901-821-0312
Practice Address - Street 1:5100 POPLAR AVE
Practice Address - Street 2:SUITE 2805
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38137-4000
Practice Address - Country:US
Practice Address - Phone:901-821-0311
Practice Address - Fax:901-821-0312
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROVIDENCE SERVICE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-11
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health