Champion Community Partners, LLC
NPI #1922989144 in Massapequa Park, New York
Provider Information
- NPI Number
- 1922989144
- Entity Type
- Organization
- Organization Name
- Champion Community Partners, LLC
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Sep 12, 2025
- Last Updated
- Sep 12, 2025
Practice Location
- Address
- 5100 SUNRISE HWY
- City
- Massapequa Park
- State
- New York
- ZIP Code
- 11762-2935
- Phone
- (631) 696-4357
Authorized Official
- Name
- TRACEY WALLACE
- Title
- VP OPS
- Phone
- (631) 696-4357
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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