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General NPI Number Information
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NPI Number | 1447219738
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Entity Type | Organization
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Legal Business Name | CAMILLUS HOUSE, INC.
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 1603 NW 7TH AVE
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City | MIAMI
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State | FL
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Zip | 33136
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Country | US
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Telephone | 305-374-1065
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Fax | 305-533-2917
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Provider Business Mailing Address
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Address Line | 1603 NW 7TH AVE
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City | MIAMI
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State | FL
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Zip | 33136-1415
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Country | US
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Telephone | 305-374-1065
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Fax | 305-533-2917
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Authorized Official
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Title or Position | DIRECTOR OF QUALITY AND OUTCOMES
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Name | MRS. JAYMEE KENT
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Credential |
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Telephone | 305-374-1065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 1113AD286202
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 13=========04
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License Number State | FL
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