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General NPI Number Information
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NPI Number | 1790732568
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Entity Type | Organization
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Legal Business Name | CHAMPION STATE CARE INC.
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16325 MELLOW OAKS LN
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City | SUGAR LAND
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State | TX
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Zip | 77478-7213
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Country | US
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Telephone | 281-242-8382
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Fax | 713-838-0356
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Provider Business Mailing Address
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Address Line | 16325 MELLOW OAKS LN
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City | SUGAR LAND
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State | TX
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Zip | 77478-7213
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Country | US
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Telephone | 281-242-8382
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Fax | 713-838-0356
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Authorized Official
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Title or Position | ADMINISTRATOR/DON
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Name | DANIEL AMARE
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Credential | RN
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Telephone | 281-242-8382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | TX
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