Champaign Residential Services, Inc.

NPI #1609014224 in Urbana, Ohio

Provider Information

NPI Number
1609014224
Entity Type
Organization
Organization Name
Champaign Residential Services, Inc.
Subpart
Yes (part of a larger organization)
Parent Organization
CHAMPAIGN RESIDENTIAL SERVICES, INC.
Primary Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date
Feb 4, 2009
Last Updated
Feb 4, 2009

Practice Location

Address
2380 ST. RT. 68 SOUTH
City
Urbana
State
Ohio
ZIP Code
43078
Phone
(937) 653-1320

Authorized Official

Name
MR. THAN JOHNSON
Title
CHIEF EXECUTIVE OFFICER
Phone
(937) 653-1320

Specialties & Taxonomy Codes

Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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