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Champagne Incorporated
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lindale, Texas
NPI 1992873715

Champagne Incorporated is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Lindale, TX. Champagne Incorporated practices in Lindale, TX. The NPI Number for Champagne Incorporated is 1992873715 and holds a License No. 117423 (Texas).

The current practice location address for Champagne Incorporated is 405 N. Main Street, Lindale, TX and can be reached out via phone at 903-882-8337 and via fax at 903-882-1627.

Location: 405 N. Main Street, Lindale, TX, 75771-1749
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1992873715
Provider Name
Champagne Incorporated
Credential
Provider Entity Type
Organization
Address
405 N. Main Street, Lindale, TX, 75771-1749
Phone Number
903-882-8337
Fax Number
903-882-1627
Provider Enumeration Date
12/01/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
007547 01 TX PROVIDER
institution
Provider Business Practice Location Address Details
Address
405 N. Main Street
City
Lindale
State
Texas
Zip
75771
Phone Number
903-882-8337
Fax Number
903-882-1627
person
Provider Business Mailing Address Details
Address
405 N. Main Street
City
Lindale
State
Texas
Zip
75771
Phone Number
903-882-8337
Fax Number
903-882-1627
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
117423 (Texas)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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