Organization
CHAMPION SUPPORTS & COMMUNITY SERVICES, INC
Active
Other names
Champion Supports & Community Services, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONYA NEWSOME GOBLE (PRESIDENT AND EXECUTIVE DIRECTOR)
(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
Enumeration date
02/08/2010
Last updated
02/08/2010
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