Healthcare Provider Details

I. General information

NPI: 1053521740
Provider Name (Legal Business Name): CAMP SUMMIT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 PRIVATE ROAD 3475
PARADISE TX
76073-4008
US

IV. Provider business mailing address

17210 CAMPBELL RD STE 180
DALLAS TX
75252-4203
US

V. Phone/Fax

Practice location:
  • Phone: 940-433-3338
  • Fax: 940-620-1945
Mailing address:
  • Phone: 972-484-8900
  • Fax: 972-620-1945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number061001
License Number StateTX

VIII. Authorized Official

Name: MS. CARLA R. WEILAND
Title or Position: CHEIF EXECUTIVE OFFICER
Credential:
Phone: 972-484-8900