Provider Demographics
NPI:1780984757
Name:CHAMPION HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:CHAMPION HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMPION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-347-0440
Mailing Address - Street 1:7601 N FEDERAL HWY STE 225A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1650
Mailing Address - Country:US
Mailing Address - Phone:561-347-0440
Mailing Address - Fax:561-347-1142
Practice Address - Street 1:7601 N FEDERAL HWY STE 225A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1650
Practice Address - Country:US
Practice Address - Phone:561-347-0440
Practice Address - Fax:561-347-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20246096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health