Provider Demographics
NPI:1760557763
Name:CAMERON GROUP CARE, INC
Entity Type:Organization
Organization Name:CAMERON GROUP CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-909-7868
Mailing Address - Street 1:PO BOX 373
Mailing Address - Street 2:625 HARRIS LANE
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-0373
Mailing Address - Country:US
Mailing Address - Phone:816-632-1677
Mailing Address - Fax:816-632-2131
Practice Address - Street 1:625 HARRIS LN
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-1121
Practice Address - Country:US
Practice Address - Phone:816-632-1677
Practice Address - Fax:816-632-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2607-9454315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities