CHAMPION FAMILY CARE HOME (NPI# 1306036223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306036223 |
| Entity Type | Organization |
| Organization Name | CHAMPION FAMILY CARE HOME |
| Practice Address |
127 Lucas Ln Mooresboro NC 28114-6799 |
| Practice Telephone | 7044347727 |
| Mailing Telephone | 7044947727 |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2007-07-26 |
| Authorized Official Name | CATHY CHAMPION (OWNER) |
| Authorized Official Telephone | 7044347727 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7805153 | 05 |
| Street Address |
127 LUCAS LN |
| City | MOORESBORO |
| State | NC |
| Zip Code | 28114-6799 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043671613 | Kd Support Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 133 Keeter Rd., Mooresboro, NC 28114 | 2016-03-10 |
| 1467862219 | Jimerson Safe Haven | Local Education Agency (LEA) | 135 Sweetbriar Circle, Mooreboro, NC 28114 | 2014-05-02 |
| 1437598265 | Mcdaniel Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 136 Fox Den Drive, Mooresboro, NC 28114 | 2013-06-14 |
| 1114295664 | Beth Paglia | Speech-Language Pathologist | 454 Lemmons Rd, Mooresboro, NC 28114 | 2011-12-12 |
| 1003947979 | Rutherford Hospital Inc | Pharmacy | 607 120 Hwy, Mooresboro, NC 28114 | 2007-03-09 |
| 1245248657 | Robert Allen Ralph | Family Medicine | 605 N C 120 Highway, Mooresboro, NC 28114-6713 | 2006-08-03 |
| 1821191875 | Rutherford Hospital, Inc. | Clinic/Center | 605 N C 120 Highway, Mooresboro, NC 28114-6713 | 2006-09-06 |
| 1669826459 | Raph Voyles Jr. | Specialist/Technologist | 942 State Line Rd, 942, Mooresboro, NC 28114-7693 | 2016-04-18 |
| 1922153329 | Country Living and More Family Care | Assisted Living Facility | 336 Nc 120 Hwy, Mooresboro, NC 28114-7788 | 2007-01-24 |
| 1609235696 | Kd Support Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1998 Harris Henrietta Rd, Mooresboro, NC 28114-8209 | 2016-02-18 |
| Find all providers in zip 28114 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070215 | My Guardian Angel Family Care Home | Custodial Care Facility | 514 Cokey Road, Rocky Mount, NC 27801 | 2020-10-15 |
| 1932692159 | Carillon Assisted Living of Garner LLC | Custodial Care Facility | 200 Minglewood Dr, Garner, NC 27529-5273 | 2018-06-12 |
| 1821598335 | Sonya Waddell | Custodial Care Facility | 6025 Dustin Ridge Ct, Rural Hall, NC 27045-9011 | 2018-02-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1518331669 | Carillon Assisted Living of Huntersville, LLC | Custodial Care Facility | 250 Commerce Center Dr, Huntersville, NC 28078 | 2015-11-30 |
| 1871961631 | Wake Forest Adult Day Care Inc | Custodial Care Facility | 3309 Rogers Rd, Suite 117, Wake Forest, NC 27587-3943 | 2015-09-10 |
| 1407238355 | Guardian Care Advisors, Inc. | Custodial Care Facility | 1320 Ashley Sq, Winston Salem, NC 27103-2919 | 2015-06-26 |
| 1275922171 | Freedom Ministries Church and Outreach | Custodial Care Facility | 539 Railway Place, Concord, NC 28025-0000 | 2015-01-15 |
| 1962803551 | Carillon Assisted Living of Clemmons, LLC | Custodial Care Facility | 1165 S Peace Haven Rd, Clemmons, NC 27012-8910 | 2014-09-15 |
| 1487062311 | Douglas Family Care | Custodial Care Facility | 1439 Us Highway 13 S, Ahoskie, NC 27910-8125 | 2014-07-23 |
| Find all providers with the same taxonomy | ||||
| City | MOORESBORO |
| Zip Code | 28114 |
Please comment or provide details below to improve the information on CHAMPION FAMILY CARE HOME.
| 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.