Champaign Residential Services, Inc.

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Mount Vernon, OH

NPI 1700258795 · NPPES record last updated Oct 29, 2015

Key facts

NPI
1700258795
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
Legal business name
CHAMPAIGN RESIDENTIAL SERVICES, INC.
Practice address
106 McKinley Ave
Mount Vernon, OH 43050-8411
Phone
(937) 653-1320
Fax
(937) 653-1321
NPI assigned
Oct 29, 2015
Organization subpart
No

Authorized official

Name
Scott A Delong
Title
President
Phone
(937) 653-1320

Corporate family (same tax ID) 17

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Champaign Residential Services Inc (18 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X OH Yes

Addresses

Primary practice location

106 McKinley Ave
Mount Vernon, OH 43050-8411

Mailing address

1150 Scioto St
PO Box 29
Urbana, OH 43078-2289
Phone (937) 653-1320

Other names

  • CRSI Doing business as

Other providers in Mount Vernon, OH

All providers in Mount Vernon, OH · Intellectual Disabilities Intermediate Care Facility in Ohio

Sources for this page

Verify at the official NPI Registry.