MEDICARE: CHAMPION LIFE HOMECARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1255177333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMPION LIFE HOMECARE

Provider Business Mailing Address
First Line	:	4764 FISHBURG RD STE E
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-5456
Country	:	US
Telephone Number	:	317-531-7990
Fax Number	:	937-660-4071

Provider Business Practice Location Address
First Line	:	4764 FISHBURG RD STE E
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45424-5456
Country	:	US
Telephone Number	:	317-531-7990
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LEILA CHAMPION
Credential	:	CDCA
Telephone Number	:	317-531-7990

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	10/27/2025

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