Champagne House

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CHAMPAGNE HOUSE

Practice address

303 Mount Sylvan St
Lindale, TX 75771-6235

Phone

(903) 882-8337

Fax

(903) 882-1627

NPI assigned

Feb 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Joy ChampagneNPI 1538236609

Title

Owner

Phone

(903) 882-8337

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013056431. Details of each certification follow.

• CCN 45G409 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 45G409

Legal name

CHAMPAGNE HOUSE

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Aug 2, 1990

Last certification

Feb 13, 2025

Beds

6 (4 certified)

Ownership / control type

Private (proprietary)

Facility address

303 Mount Sylvan Rd
Lindale, TX 75771

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joy Champagne

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Lindale, TX
  • NPI 1538236609

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013056431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1749",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757711749",
            "telephone_number": "903-882-8337",
            "fax_number": "903-882-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MOUNT SYLVAN ST",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757716235",
            "telephone_number": "903-882-8337",
            "fax_number": "903-882-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPAGNE HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAMPAGNE",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-882-8337",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cannery Pharmacy Services LLC
• Cannery Pharmacy Services LLC
• Allyson Elaine Carter
• Haley Castillo
• Lindsay Chamberlain, LPC
• Champagne Incorporated
• Champagne, Inc. (Jeffries House)
• Joy Champagne
• Chiropractic Professionals of Lindale PC (Lindale Chiropractic Clinic)
• City of Ennis (Lindale Healthcare Center)

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lindale, TX
• Providers in Lindale, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.