Williams Street

LBN: Champaign Residential Services, Inc.
Williams Street is an health care organization with primary practice located at 821 West Williams Street , Bellefontaine OH 43311. 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
821 West Williams Street Bellefontaine OH 43311
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 1578701199
LBN Legal business name Champaign Residential Services, Inc.
DBA Doing business as Williams Street
Authorized official Johnson, Than
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 4th, 2009
Last updated Feb 4th, 2009 - about 16 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 1578701199 NPPES
Ohio MEDICAID 0123986

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