Champaign Residential Services, Inc.

NPI #1780057661 in Tiffin, Ohio

Provider Information

NPI Number: 1780057661
Entity Type: Organization
Organization Name: Champaign Residential Services, Inc.
Primary Specialty: Intermediate Care Facility, Intellectual Disabilities
Enumeration Date: Nov 2, 2015
Last Updated: Nov 2, 2015

Practice Location

Address: 58 ORCHARD PARK
City: Tiffin
State: Ohio
ZIP Code: 44883
Phone: (937) 653-1320

Authorized Official

Name: SCOTT A DELONG
Title: PRESIDENT
Phone: (937) 653-1320

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Intermediate Care Facility, Intellectual Disabilities	315P00000X	Primary

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