Provider Demographics
NPI:1861887101
Name:CAMP HEALTHCARE PARTNERS LLC
Entity type:Organization
Organization Name:CAMP HEALTHCARE PARTNERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:G
Authorized Official - Last Name:GLADNEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:318-281-0078
Mailing Address - Street 1:1523 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-4043
Mailing Address - Country:US
Mailing Address - Phone:318-281-0078
Mailing Address - Fax:318-281-2753
Practice Address - Street 1:1638 VZ CR 1803
Practice Address - Street 2:
Practice Address - City:GRAND SALINE
Practice Address - State:TX
Practice Address - Zip Code:75140-3494
Practice Address - Country:US
Practice Address - Phone:903-962-7595
Practice Address - Fax:903-962-7202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1026844Medicaid
TX675878Medicare Oscar/Certification