Organization · NPI-2

Camelot Senior Living, INC.

Custodial Care Facility · Sacramento, CA

NPI number1053521096
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1053521096
Entity type
Organization (NPI-2)
Legal business name
Camelot Senior Living, INC.
Organization subpart
No
Enumeration date
May 22, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
311Z00000X Custodial Care Facility347000399CAYes

Other names

  • Camelot Care Home 1 (Doing Business As)

Practice location

8006 Bucks Harbor Way
Sacramento, CA 95828-5435

Phone 916-803-1955 · Fax 916-685-6343

Mailing address

8716 Milo Ct
Elk Grove, CA 95624-1817

Phone 916-803-1955 · Fax 916-685-6343

Authorized official

Scott Emerson Dahlquist
President
9168031955

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