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Organization
SUPPORT CHAMPIONS, LLC
Active
Organization
SUPPORT CHAMPIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA JACKSON (OWNER)
(813) 610-9763
Entity
Organization
Contact information
Practice address
9407 OAK MEADOW CT, TAMPA, FL 33647-2526
(813) 610-9763
(813) 436-5251
Mailing address
PO BOX 82127, TAMPA, FL 33682-2127
(813) 610-9763
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
Other
Enumeration date
11/16/2018
Last updated
11/16/2018
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