NPI 1295973824

Champaign Residential Services, INC.

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Urbana, OH

Practice location

Address: 334 Scioto Street, Urbana, OH 43078
Phone: (937) 653-1320
Fax: (937) 653-1321
Mailing address: P.O. Box 29, Urbana, OH 43078-0029

Authorised official

Name: Than Johnson
Title: Chief Executive Officer
Phone: (937) 653-1320

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1295973824
Entity type: Organization
NPI issued: 4 Feb 2009
Record last updated: 4 Feb 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.