Provider Demographics
NPI:1194330506
Name:CHAMPION COMMUNITY CARE, LLC
Entity type:Organization
Organization Name:CHAMPION COMMUNITY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANCHAISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-470-5850
Mailing Address - Street 1:108 BLAKESMOOR RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-5159
Mailing Address - Country:US
Mailing Address - Phone:803-470-5850
Mailing Address - Fax:
Practice Address - Street 1:108 BLAKESMOOR RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-5159
Practice Address - Country:US
Practice Address - Phone:803-470-5850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health