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NPI Code Detail

MEDICARE: CHAMPION PHASES LLC

MEDICARE: CHAMPION PHASES LLC
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
1251S00000XCommunity/Behavioral Health Agency
2347C00000XPrivate Vehicle
3253Z00000XIn Home Supportive Care Agency
4332U00000XHome Delivered Meals
5343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1841098316
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHAMPION PHASES LLC
Provider Business Mailing Address
First Line : 2014 CHAMPIONS GTWY NW STE 301
Second Line :
City : CANTON
State : OH
Zip : 44708-2605
Country : US
Telephone Number : 330-313-4941
Fax Number :
Provider Business Practice Location Address
First Line : 2014 CHAMPIONS GTWY NW STE 301
Second Line :
City : CANTON
State : OH
Zip : 44708-2605
Country : US
Telephone Number : 330-313-4941
Fax Number :
Authorized Official
Title or Position : CEO/FOUNDER
Name : RASHAN HALL
Credential : QBHS,
Telephone Number : 330-313-4941
Provider Enumeration Date : 03/03/2025
Last Update Date : 03/03/2025

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Directions to “CHAMPION PHASES LLC ” Practice Location

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