HOME OF CHAMPIONS (NPI# 1245882588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245882588 |
| Entity Type | Organization |
| Organization Name | HOME OF CHAMPIONS |
| Practice Address |
7816 Whitney Ln Fort Worth TX 76112-6168 |
| Practice Telephone | 8178993132 |
| Practice Fax Number | 8885884001 |
| Mailing Telephone | 8178993132 |
| Mailing Fax Number | 8885884001 |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-16 |
| Authorized Official Name | JANE HOUSTON (ADMINISTRATOR) |
| Authorized Official Telephone | 8178993132 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Home of Champions Inc. | 211 E. White Avenue, Trinidad, CO 81082 |
| Street Address |
7816 WHITNEY LN |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76112-6168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396211397 | Shelia Minor | Home Health Aide | 5648 Victoria Place, Fort Worth, TX 76112 | 2018-10-17 |
| 1457833816 | Joanne Medford | Physical Therapy Assistant | 1704 Wilson Rd, Fort Worth, TX 76112 | 2018-09-02 |
| 1821525502 | Kids & Hugs Home Therapy | Home Health | 2317 Maryel Dr., Fort Worth, TX 76112 | 2017-05-12 |
| 1932516846 | Neuroassessment Services LLC | Clinical Neuropsychologist | 5601 Bridge Street, Suite 500, Ft. Worth, TX 76112 | 2014-07-14 |
| 1114346335 | Blessed Beginnings | Day Training, Developmentally Disabled Services | 2320 Blue Smoke Court North, Fort Worth, TX 76112 | 2014-04-15 |
| 1790035517 | Transitions for Success Inc | In Home Supportive Care | 6228 Warrington Pl Ace, Fort Worth, TX 76112 | 2012-09-19 |
| 1194048116 | Jerlene Bonner Tippett | Home Health Aide | 1701 Bunch Dr, Ft Worth, TX 76112 | 2010-03-04 |
| 1396076543 | Roy Kenji Yamada | Emergency Medicine | 5800 Forest Bend Pl., Ft. Worth, TX 76112 | 2010-01-27 |
| 1437488228 | Rose A Miller | Case Manager/Care Coordinator | 7312 Laurie Drive, Ft. Worth, TX 76112 | 2009-12-08 |
| 1174760508 | Advocate Angels | Case Management | 6829 Gary Lane, Fort Worth, TX 76112 | 2009-01-07 |
| Find all providers in zip 76112 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609378603 | Ridglea Senior Living 2015, LLC | Assisted Living Facility | 4109 Westridge Ave, Fort Worth, TX 76116-7410 | 2018-03-06 |
| 1235657008 | Genesis Gardens, Inc. | Assisted Living Facility | 174 Sycamore School Rd, Fort Worth, TX 76134-5008 | 2017-08-31 |
| 1760914469 | Southwest Ltc - Fort Worth Alf, LLC | Assisted Living Facility | 6931 River Park Cir, Fort Worth, TX 76116-8465 | 2017-03-31 |
| 1558893701 | Southwest Ltc - Fort Worth Alf, LLC | Assisted Living Facility | 6939 River Park Cir, Fort Worth, TX 76116-8465 | 2017-03-28 |
| 1649533910 | All In All Home Healthcare Agency | Assisted Living Facility | 5938 Bayside Dr, Fort Worth, TX 76132-2645 | 2012-06-20 |
| 1477832681 | Circle of Helping Hands LLC | Assisted Living Facility | 6405 Greenbriar Lane, Fort Worth, TX 76132-3037 | 2011-08-05 |
| 1043505175 | Angels Haven, LLC | Assisted Living Facility | 2724 Calico Rock Dr, Fort Worth, TX 76131-2034 | 2011-06-16 |
| 1174816912 | Griffin Manor | Assisted Living Facility | 1428 Queens Brook Ln, Fort Worth, TX 76140-5747 | 2011-05-26 |
| 1407180292 | Chritian Love Foundation | Assisted Living Facility | 6325 Vel Dr, Fort Worth, TX 76112-8035 | 2009-09-25 |
| 1588806798 | Lane's Assisted Living Facility LLC | Assisted Living Facility | 2617 Carolina Dr, Fort Worth, TX 76123-1661 | 2009-04-02 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76112 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.