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JACKSON LANE
NPI 1184074650
Intermediate Care Facility, Intellectual Disabilities in Middletown, OH

Active since June 15, 2016
1909 JACKSON LANE, MIDDLETOWN, OH 45042(513) 858-4550 Get Directions Write a Review

NPPES record last updated: June 15, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jackson Lane NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON LANE (NPI 1184074650) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Middletown, Ohio and active in the NPI registry since June 2016. The organization lists Mary A Pank, Paralegal, as its authorized official.

NPPES Registry Identity

NPI1184074650
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameCAMELOT REALTY, LLC
Location Address1909 JACKSON LANEMiddletown, OH 45042
Mailing Address9901 Linn Station RdLouisville, KY 40223-3808 · (502) 394-2100
Phone(513) 858-4550
Organization SubpartNo
Authorized OfficialMary A PankParalegal · (502) 420-2666
Enumeration DateJune 15, 2016
✔ NPI 1184074650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
1909 JACKSON LANE, Middletown, OH 45042
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Other Names 1

Other NameJackson Lane

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Camelot Realty, LLC's NPI number?

The NPI number for Camelot Realty, LLC is 1184074650. It was assigned to this organization in the NPPES registry on June 15, 2016. The provider is also known as Jackson Lane.

Where is Camelot Realty, LLC located?

Camelot Realty, LLC is located at 1909 Jackson Lane, Middletown, OH 45042. The listed phone number is (513) 858-4550.

What is Camelot Realty, LLC's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Camelot Realty, LLC was last updated on June 15, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.