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General NPI Number Information
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NPI Number | 1487470860
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Entity Type | Organization
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Legal Business Name | CHAMPIONS OF CARING CONNECTIONS
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1019 N HARRIS AVE
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City | COMPTON
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State | CA
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Zip | 90221-2421
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Country | US
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Telephone | 310-635-9536
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Fax | 310-933-8966
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Provider Business Mailing Address
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Address Line | PO BOX 5253
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City | COMPTON
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State | CA
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Zip | 90224-5253
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Country | US
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Telephone | 310-635-9536
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Fax | 310-933-8966
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BETTYE RANDLE
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Credential |
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Telephone | 310-635-9536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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