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General NPI Number Information
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NPI Number | 1447283270
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Entity Type | Organization
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Legal Business Name | CHAMPION CARE, INC
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 1419 MARKET ST
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City | LAREDO
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State | TX
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Zip | 78040
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Country | US
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Telephone | 956-712-2156
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Fax | 956-727-7861
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Provider Business Mailing Address
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Address Line | 1419 MARKET ST
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City | LAREDO
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State | TX
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Zip | 78040-8841
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Country | US
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Telephone | 956-712-2156
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Fax | 956-727-7861
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Authorized Official
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Title or Position | DIRECTOR/CEO/CFO
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Name | YOLINDA TREVINO
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Credential | RN
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Telephone | 956-718-2777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 004883
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License Number State | TX
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