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General NPI Number Information
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NPI Number | 1609685999
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Entity Type | Organization
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Legal Business Name | CAMELLIA PINE HOME CARE INC
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 600 BEL AIR BLVD STE 140
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City | MOBILE
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State | AL
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Zip | 36606-3501
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Country | US
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Telephone | 251-725-0265
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Fax |
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Provider Business Mailing Address
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Address Line | 600 BEL AIR BLVD STE 140
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City | MOBILE
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State | AL
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Zip | 36606-3501
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Country | US
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Telephone | 251-725-0265
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHENITA PORTER
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Credential |
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Telephone | 346-460-3057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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