NPIMap

Organization Active NPI

Champion Life House

Doing business as Champion Life Network

  • Community/Behavioral Health Agency
  • Huber Heights, OH
National Provider Identifier
1982415246
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHAMPION LIFE HOUSE
Doing business as
Champion Life Network
Practice address
4764 Fishburg Rd Ste E
Huber Heights, OH 45424-5456
Phone
(317) 531-7990
NPI assigned
Jan 16, 2025
Organization subpart
Yes
Parent organization
CHAMPION LIFE HOUSEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Leila Champion
Title
Administrator
Phone
(317) 531-7990

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social Worker 1041C0700X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary
Respite Care Camp 385HR2050X
Child Mental Illness Respite Care 385HR2055X

Addresses

Primary practice location

4764 Fishburg Rd Ste E
Huber Heights, OH 45424-5456

Mailing address

4764 Fishburg Rd Ste E
Huber Heights, OH 45424-5456
Phone (317) 531-7990

Other names 1

  • Champion Life Network Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Champion Life Homecare3 organizations share this tax ID, including this one
Part of
Champion Life Homecare

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1982415246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4764 FISHBURG RD STE E",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454245456",
            "telephone_number": "317-531-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4764 FISHBURG RD STE E",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454245456",
            "telephone_number": "317-531-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION LIFE HOUSE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHAMPION LIFE HOUSE",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "CHAMPION",
        "authorized_official_first_name": "LEILA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "317-531-7990"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champion Life Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huber Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.