Organization
CHAMPION HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BYRON WILLIAMS (CEO)
(919) 434-5100
Entity
Organization
Contact information
Practice address
201 E 5TH ST STE 1900, CINCINNATI, OH 45202-4162
(919) 434-5100
Mailing address
2949 NEW BERN AVE STE 108A, RALEIGH, NC 27610-1248
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
447378
—
OH
Enumeration date
07/09/2019
Last updated
08/06/2020
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