Organization
CHAMPION SUPPORTS & SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA DEE NEWSOME-SANDERS (EXECUTIVE DIRECTOR & PRESIDENT)
(606) 432-8666
Entity
Organization
Contact information
Practice address
3409 N MAYO TRL, PIKEVILLE, KY 41501-3268
(606) 432-8666
(606) 432-8159
Mailing address
3409 N MAYO TRL, PIKEVILLE, KY 41501-3268
(606) 432-8666
(606) 432-8159
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33000779
—
KY
Enumeration date
01/16/2007
Last updated
08/22/2020
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