Organization
CHAMPAGNE INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOY CHAMPAGNE (PRESIDENT)
(903) 882-8337
Entity
Organization
Contact information
Practice address
405 N. MAIN STREET, LINDALE, TX 75771
(903) 882-8337
(903) 882-1627
Mailing address
PO BOX 1749, LINDALE, TX 75771-1749
(903) 882-8337
(903) 882-1627
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
117423
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007547
PROVIDER
TX
Enumeration date
12/01/2006
Last updated
08/22/2020
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