Champaign Residential Services, Inc.

LBN: Champaign Residential Services, Inc.
Champaign Residential Services, Inc. is an health care organization with primary practice located at 1150 Scioto St Suite 100, Urbana OH 43078-2289. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Champaign Residential Services, Inc. can be contacted via phone (937) 653-1320, or through Johnson, Than via phone (937) 653-1320.

Contact Information

Primary practice address
1150 Scioto St Suite 100 Urbana OH 43078-2289
Phone: (937) 653-1320
Fax: (937) 653-1321
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Than
Phone: (937) 653-1320

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X

Profile Details

NPI number 1033264619
LBN Legal business name Champaign Residential Services, Inc.
DBA Doing business as
Authorized official Johnson, Than
Entity Organization
Organization subpart 1 No
Enumeration date Jan 24th, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033264619 NPPES
Ohio Other 1100114 WAIVER BILLING PROVIDER #
Ohio MEDICAID 0850637 WAIVER BILLING PROVIDER #

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