CHAMPAIGN RESIDENTIAL SERVICES, INC. (NPI# 1295973824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295973824 |
| Entity Type | Organization |
| Organization Name | CHAMPAIGN RESIDENTIAL SERVICES, INC. |
| Other Organization Name | SCIOTO STREET |
| Practice Address |
334 Scioto Street Urbana OH 43078 |
| Mailing Address |
P.o. Box 29 Urbana OH 43078-0029 |
| Practice Telephone | 9376531320 |
| Practice Fax Number | 9376531321 |
| Mailing Telephone | 9376531320 |
| Mailing Fax Number | 9376531321 |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-04 |
| Authorized Official Name | MR. THAN JOHNSON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9376531320 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHAMPAIGN RESIDENTIAL SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0583793 | 05 |
| Other Name | Type Code |
|---|---|
| Scioto Street | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780057661 | Champaign Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 58 Orchard Park, Tiffin, OH 44883 | 2015-11-02 |
| 1700258795 | Champaign Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 106 Mckinley Ave, Mount Vernon, OH 43050-8411 | 2015-10-29 |
| 1790156529 | Champaign Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 200 S Norton St, Mount Vernon, OH 43050-4024 | 2015-10-20 |
| 1912146572 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 141 Richard Avenue, Bellefontaine, OH 43311 | 2009-02-05 |
| 1861631426 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 400 Oakland Street, Urbana, OH 43078 | 2009-02-05 |
| 1437398054 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2450 Mandolin Drive, Lima, OH 45804 | 2009-02-05 |
| 1710126370 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 329 East Spring Avenue, Bellefontaine, OH 43311 | 2009-02-05 |
| 1649418252 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 124 Hill Street, Urbana, OH 43078 | 2009-02-04 |
| 1609014224 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2380 St. Rt. 68 South, Urbana, OH 43078 | 2009-02-04 |
| 1437397031 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 809 South High Street, Urbana, OH 43078 | 2009-02-04 |
| Street Address |
334 SCIOTO STREET |
| City | URBANA |
| State | OH |
| Zip Code | 43078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750851812 | Alicia Susanne Mcguire | Case Manager/Care Coordinator | 1522 West Us Highway 36, Suite A, Urbana, OH 43078 | 2018-12-03 |
| 1962998674 | Emily Holland | Counselor | 1522 East Us Rte 36, Suite A, Urbana, OH 43078 | 2018-07-05 |
| 1790235638 | Scott Kayatin | Chiropractor | 1598 E Us Highway 36, Urbana, OH 43078 | 2016-10-04 |
| 1053778522 | Holly Bowman | Specialist | 888 East Court Street, Urbana, OH 43078 | 2016-01-28 |
| 1932512142 | Amanda Myers | Nurse Practitioner | 204 Patrick Avenue, Urbana, OH 43078 | 2014-06-05 |
| 1700201290 | Laura Nichole Steele | Speech-Language Pathologist | 2200 Us 68, Urbana, OH 43078 | 2014-02-20 |
| 1255769394 | Kimberly A. G. Leichty | Counselor | 1522 East Us Rte 36, Suite A, Urbana, OH 43078 | 2013-10-29 |
| 1912249186 | Jessica Thomas | Licensed Practical Nurse | 520 E Water St, Urbana, OH 43078 | 2013-03-26 |
| 1699053884 | Terry Means | Social Worker | 1522 E Us Rte 36, Suite A, Urbana, OH 43078 | 2011-07-22 |
| 1619277860 | Vectren | Home Infusion | 7587 W St Rt 29, Urbana, OH 43078 | 2010-10-21 |
| Find all providers in zip 43078 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861631426 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 400 Oakland Street, Urbana, OH 43078 | 2009-02-05 |
| 1649418252 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 124 Hill Street, Urbana, OH 43078 | 2009-02-04 |
| 1609014224 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2380 St. Rt. 68 South, Urbana, OH 43078 | 2009-02-04 |
| 1437397031 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 809 South High Street, Urbana, OH 43078 | 2009-02-04 |
| 1033264619 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1150 Scioto St, Suite 100, Urbana, OH 43078-2289 | 2007-01-24 |
| 1215055371 | Lakeshores Residential Care Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 27 Hopper Trl, Urbana, MO 65767-9234 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053801 | Vip of Ohio, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2446 Audubon Rd, Akron, OH 44320-1010 | 2020-11-03 |
| 1871190280 | Gateways To Better Living Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6000 Mahoning Ave Ste 234, Youngstown, OH 44515-2225 | 2020-10-08 |
| 1235746264 | Cheryl L Nelson | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 21891 Ringgold Southern Rd, Circleville, OH 43113-9263 | 2020-09-24 |
| 1164039244 | Amberdawn E Kenworthy-byers | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3746 Hickory Ln, Greenville, OH 45331-3014 | 2020-09-23 |
| 1467067124 | Forever Care LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5240 Northtowne Blvd Apt C, Columbus, OH 43229-4661 | 2020-09-10 |
| 1174177737 | Alive Now Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6717 Amsel Ave Ne, Canton, OH 44721-2606 | 2019-07-31 |
| 1154846095 | Anitra L Richardson | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3321 Hackberry St, Cincinnati, OH 45207-1701 | 2017-08-11 |
| 1811447519 | Royal Queens Care Agency | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6625 Retton Rd, Reynoldsburg, OH 43068-2849 | 2016-10-06 |
| 1962958512 | Individual | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1111 Gonder Av Se, Canton, OH 44707 | 2016-09-01 |
| 1700238391 | Rose-mary, The Johanna Grasselli Rehabilitation and Education Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4383 Ammon Rd, Cleveland, OH 44143-2803 | 2016-07-07 |
| Find all providers with the same taxonomy | ||||
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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.