| NPI | 1952061061 |
|---|---|
| Doing Business As | CAMELOT BROOKSIDE |
| Entity Type | Organization |
| Authorized Contact | STEVEN BOULWARE Managing Member 972-428-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2021-12-30 |
| Last Update Date | 2021-12-30 |