Provider Demographics
NPI:1558991562
Name:CHAMPION HOME TRANSITIONS
Entity Type:Organization
Organization Name:CHAMPION HOME TRANSITIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:JOANNE
Authorized Official - Last Name:BONIFAZI
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:720-300-2432
Mailing Address - Street 1:1887 ROSS LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-4050
Mailing Address - Country:US
Mailing Address - Phone:720-404-0757
Mailing Address - Fax:720-207-9919
Practice Address - Street 1:1887 ROSS LN
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-4050
Practice Address - Country:US
Practice Address - Phone:720-404-0757
Practice Address - Fax:720-207-9919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management