MEDICARE: CAMELOT COMMUNITY CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629339882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMELOT COMMUNITY CARE, INC

Provider Business Mailing Address
First Line	:	4910 CREEKSIDE DR STE D
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33760-4034
Country	:	US
Telephone Number	:	727-593-0003
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 W THARPE ST
Second Line	:	SUITE 7
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-5374
Country	:	US
Telephone Number	:	850-561-8060
Fax Number	:	850-561-1143

Authorized Official
Title or Position	:	DIRECTOR OF AR
Name	:	JANA ALLEN
Credential	:
Telephone Number	:	727-593-0003

Provider Enumeration Date	:	06/05/2012
Last Update Date	:	08/19/2021

Similar Medicare Providers

1770166456 — MADISON LYNN HENZEL
Practice Location Address:

1000 W THARPE ST
TALLAHASSEE, FL
32303-5374

Practice Phone: 813-295-8383
Practice Fax:

1164563979 — MS. MELANIE SUSAN WEBB M.S., CRC
Practice Location Address:

1000 W THARPE ST
TALLAHASSEE, FL
32303-5374

Practice Phone: 904-864-4338
Practice Fax:

1639484777 — TWILA JOWERS LCSW
Practice Location Address:

1000 W THARPE ST , SUITE 7
TALLAHASSEE, FL
32303-5374

Practice Phone: 850-591-3085
Practice Fax:

1770830572 — CHAD ROBERT SEDAM M.S., CRC
Practice Location Address:

1000 W THARPE ST , SUITE #7
TALLAHASSEE, FL
32303-5374

Practice Phone: 850-561-8060
Practice Fax:

1619225794 — BOBBI NICOLE MOUNT M.S.W.
Practice Location Address:

1000 W THARPE ST , SUITE 7
TALLAHASSEE, FL
32303-5374

Practice Phone: 850-561-8060
Practice Fax: 850-561-1143

1689922767 — ABEDE FITZROY TESFA M.S./ED.S.
Practice Location Address:

1000 W THARPE ST , SUITE 7
TALLAHASSEE, FL
32303-5374

Practice Phone: 850-561-8060
Practice Fax: 850-561-1143

Directions to “CAMELOT COMMUNITY CARE, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.