Provider Demographics
NPI:1932311693
Name:CAMERON HEALTHCARE INC.
Entity Type:Organization
Organization Name:CAMERON HEALTHCARE INC.
Other - Org Name:THE VILLAGE WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADM OFFICE MGR OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-632-1121
Mailing Address - Street 1:318 E LITTLE BRICK ST
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429
Mailing Address - Country:US
Mailing Address - Phone:816-632-1121
Mailing Address - Fax:816-632-6045
Practice Address - Street 1:318 E LITTLE BRICK ST
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429
Practice Address - Country:US
Practice Address - Phone:816-632-1121
Practice Address - Fax:816-632-6045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO033245311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility