A Champion Home & Community Services

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

A CHAMPION HOME & COMMUNITY SERVICES

Doing business as

A Champion Home & Community Services

Practice address

119 Executive Way Ste 303
Desoto, TX 75115-2341

Phone

(469) 463-3054

Fax

(214) 306-6035

NPI assigned

Mar 5, 2012

Last updated

Mar 19, 2024By 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

Trace Hendersom

Title

Program Manager

Phone

(469) 463-3054

Specialties & licenses 1

Addresses

Other names 1

• A Champion Home & Community Services Doing business as

Locations

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1609140920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 EXECUTIVE WAY STE 303",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152341",
            "telephone_number": "469-463-3054",
            "fax_number": "214-306-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 EXECUTIVE WAY STE 303",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152341",
            "telephone_number": "469-463-3054",
            "fax_number": "214-306-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A CHAMPION HOME & COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "HENDERSOM",
        "authorized_official_first_name": "TRACE",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "469-463-3054"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Champion Home & Community Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foster Care Agency in Desoto, TX
• Providers in Desoto, TX by specialty
• Foster Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.