Provider Demographics
NPI:1780417360
Name:CHAMPION HEALTHCARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:CHAMPION HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOSHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-394-1623
Mailing Address - Street 1:56 CLAYTON ENGLISH DR
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-9441
Mailing Address - Country:US
Mailing Address - Phone:404-955-9108
Mailing Address - Fax:770-914-1690
Practice Address - Street 1:1953 OLD ATLANTA RD
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-1180
Practice Address - Country:US
Practice Address - Phone:404-955-9108
Practice Address - Fax:770-914-1690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care