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(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Intermediate Care Facility, Mentally Retarded |
315P00000X |
| NPI Number | 1790992683 |
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| LBN Legal business name | THE CAMELOT SOCIETY | ||||
| Authorized official | AUTUMN CALKINS - (EXECUTIVE DIRECTOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 05/17/2007 | ||||
| Last updated | 08/22/2020 - About 6 years ago | ||||
| Identifiers |
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THE CAMELOT SOCIETY
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| THE CAMELOT SOCIETY 26509 N.E. VIRGINIA ST. DUVALL, WA |
| BRITA M HANSON 301 N BROADWAY ST ABERDEEN, WA |
| STEPHEN P MONTOURE, CDPT 224 E WISHKAH ST ABERDEEN, WA |
| ALEXA MAHAN 18311 BOTHELL-EVERETT HIGHWAY 98012, BOTHELL, WA, WA |
| JAMIE K MCINTYRE, LMT 410 E NORTH BEND WAY 98045, WA |
| JAVON J WILSON, BT 18311 BOTHELL-EVERETT HIGHWAY 98012, BOTHELL, WA, WA |
THE CAMELOT SOCIETY