| Organization Name: | CAMELLIA HEALTHCARE |
| NPI Number: | 1760886253 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JENNIFER LEE CAVENY (COO) |
| Mailing Address: | 135 Mayfair Rd Hattiesburg |
| State: | MS US |
| Postal Code: | 394021464 |
| Phone Number: | 6015442900 |
| Fax Number: | 6015796991 |
| NPI Enumeration Date: | 10/14/2014 |
| NPI Last Update Date: | 10/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |