Organization
CHAMPION LIFE HOUSE
Active
Parent organization
CHAMPION LIFE HOUSE
Other names
Champion Life Network
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHAMPION LIFE HOUSE
Authorized official
LEILA CHAMPION (ADMINISTRATOR)
(317) 531-7990
Entity
Organization
Contact information
Practice address
4764 FISHBURG RD STE E, HUBER HEIGHTS, OH 45424-5456
(317) 531-7990
Mailing address
4764 FISHBURG RD STE E, HUBER HEIGHTS, OH 45424-5456
(317) 531-7990
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
385HR2050X
Respite Care Camp
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
01/16/2025
Last updated
01/16/2025
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