Provider Demographics
NPI:1194467910
Name:CAMELOT HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:CAMELOT HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-946-5454
Mailing Address - Street 1:817 ALLEN POND RD
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:ME
Mailing Address - Zip Code:04236-3640
Mailing Address - Country:US
Mailing Address - Phone:207-946-5454
Mailing Address - Fax:
Practice Address - Street 1:817 ALLEN POND RD
Practice Address - Street 2:
Practice Address - City:GREENE
Practice Address - State:ME
Practice Address - Zip Code:04236-3640
Practice Address - Country:US
Practice Address - Phone:207-946-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care