Provider Demographics
NPI:1053113183
Name:CAMELLIA CARE
Entity type:Organization
Organization Name:CAMELLIA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:985-640-0380
Mailing Address - Street 1:90 CHAMALE CV
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460-2576
Mailing Address - Country:US
Mailing Address - Phone:985-640-0380
Mailing Address - Fax:
Practice Address - Street 1:2048 FRONT ST
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3436
Practice Address - Country:US
Practice Address - Phone:985-503-8586
Practice Address - Fax:985-326-7484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care