CHAMPAIGN RESIDENTIAL SERVICES, INC. (NPI# 1780057661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780057661 |
| Entity Type | Organization |
| Organization Name | CHAMPAIGN RESIDENTIAL SERVICES, INC. |
| Other Organization Name | CRSI |
| Practice Address |
58 Orchard Park Tiffin OH 44883 |
| Mailing Address |
1150 Scioto St Po Box 29 Urbana OH 43078-2289 |
| Practice Telephone | 9376531320 |
| Practice Fax Number | 9376531321 |
| Mailing Telephone | 9376531320 |
| Mailing Fax Number | 9376531321 |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2015-11-02 |
| Authorized Official Name | SCOTT A DELONG (PRESIDENT) |
| Authorized Official Telephone | 9376531320 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | OH | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| CRSI | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700258795 | Champaign Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 106 Mckinley Ave, Mount Vernon, OH 43050-8411 | 2015-10-29 |
| 1790156529 | Champaign Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 200 S Norton St, Mount Vernon, OH 43050-4024 | 2015-10-20 |
| 1912146572 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 141 Richard Avenue, Bellefontaine, OH 43311 | 2009-02-05 |
| 1861631426 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 400 Oakland Street, Urbana, OH 43078 | 2009-02-05 |
| 1437398054 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2450 Mandolin Drive, Lima, OH 45804 | 2009-02-05 |
| 1710126370 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 329 East Spring Avenue, Bellefontaine, OH 43311 | 2009-02-05 |
| 1649418252 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 124 Hill Street, Urbana, OH 43078 | 2009-02-04 |
| 1295973824 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 334 Scioto Street, Urbana, OH 43078 | 2009-02-04 |
| 1609014224 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2380 St. Rt. 68 South, Urbana, OH 43078 | 2009-02-04 |
| 1437397031 | Champaign Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 809 South High Street, Urbana, OH 43078 | 2009-02-04 |
| Street Address |
58 ORCHARD PARK |
| City | TIFFIN |
| State | OH |
| Zip Code | 44883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255758 | Aaron Michael Konkle | Pharmacist | 2801 State Route 18, Tiffin, OH 44883 | 2020-11-04 |
| 1487286159 | Sandra Natole | Counselor | 200 St Francis Ave, Tiffin, OH 44883 | 2020-02-10 |
| 1083260988 | Trilogy Healthcare of Tiffin, LLC | Skilled Nursing Facility | 410 Fair Lane, Tiffin, OH 44883 | 2019-08-15 |
| 1801440250 | Kenneth Oswald | Counselor | 3055 S Sr 100, Tiffin, OH 44883 | 2019-07-24 |
| 1932764107 | Cuadra Pediatric Dentistry, LLC | Dentist | Cuadra Pediatric Dentistry, LLC, 486 Wentz Street, Tiffin, OH 44883 | 2019-05-03 |
| 1578033114 | Morgan Leann Fultz | Student in an Organized Health Care Education/Training Program | 310 East Market St, Tiffin, OH 44883 | 2018-11-27 |
| 1568989630 | Alicia Taylor Frank | Speech-Language Pathologist | 797 E. Clinton Tr 201, Tiffin, OH 44883 | 2017-08-29 |
| 1861938920 | Devin Erika Fry | Physical Therapy Assistant | 2550 Oh-100, Tiffin, OH 44883 | 2017-01-13 |
| 1407392608 | Erica Hoffman | Occupational Therapy Assistant | 2550 Oh 100, Tiffin, OH 44883 | 2017-01-11 |
| 1164973509 | Spencers Home Modifications | Contractor | 8 High Pointe Court, Tiffin, OH 44883 | 2016-10-20 |
| Find all providers in zip 44883 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497127518 | Champaign Residential Services, Inc | Intermediate Care Facility, Mentally Retarded | 2976 W. Us 224, Tiffin, OH 44883 | 2015-10-28 |
| 1871964650 | Champaign Residential Services Inc | Intermediate Care Facility, Mentally Retarded | 12 Orchard Park, Tiffin, OH 44883 | 2015-10-19 |
| 1275686602 | Tiffin Developmental Center | Intermediate Care Facility, Mentally Retarded | 600 N River Rd, Tiffin, OH 44883-1173 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020616 | Viaquest Healthcare Central | Intermediate Care Facility, Mentally Retarded | 6873 Dave Dr, Madison, OH 44057-1105 | 2020-10-15 |
| 1366056210 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 410 Abbe Road, Sheffield Lake, OH 44054 | 2020-09-08 |
| 1619581568 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 460 Abbe Road, Sheffield Lake, OH 44054 | 2020-09-08 |
| 1548874589 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 448 Opportunity Way, Lagrange, OH 44050-9021 | 2020-09-08 |
| 1194339044 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 5230 East Lake Road, Sheffield Lake, OH 44054 | 2020-09-08 |
| 1326652496 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 801 Robinwood, Sheffield Lake, OH 44054 | 2020-09-04 |
| 1346854890 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 426 Opportunity Way, Lagrange, OH 44050-9021 | 2020-09-02 |
| 1144841438 | Wood Lane Residential Services | Intermediate Care Facility, Mentally Retarded | 355 W Main St., Portage, OH 43451-9802 | 2020-04-28 |
| 1689209009 | 333 Therapeutics Consulting LLC | Intermediate Care Facility, Mentally Retarded | 331 Toby Rd, Eaton, OH 45320-9529 | 2020-03-05 |
| 1700418258 | Jewish Family Service Association | Intermediate Care Facility, Mentally Retarded | 8132 Cedar Rd, Chesterland, OH 44026-3548 | 2020-02-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.