Champions For Life INC
Community/Behavioral Health in Grand Prairie, TX. Organization (NPI-2).
NPI number1942911755
StatusActive
Last updated in NPPESDec 13, 2022
Details
- NPI
- 1942911755
- Entity type
- Organization (NPI-2)
- Legal business name
- Champions For Life INC
- Organization subpart
- No
- Enumeration date
- Dec 13, 2022
- Certification date
- Dec 13, 2022
- Last updated
- Dec 13, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 251B00000X | Case Management | – | – |
Practice location
7402 Lake Ridge Pkwy Apt 1119Grand Prairie, TX 75054-0340
Phone 919-521-7274
Mailing address
7402 Lake Ridge Pkwy Apt 1119Grand Prairie, TX 75054-0340
Authorized official
Maurice Frink
Owner
9195217274
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