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CHAMPAIGN RESIDENTIAL SERVICES, INC.
NPI 1033264619
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Urbana, OH

Active since January 24, 2007
1150 SCIOTO ST, SUITE 100, URBANA, OH 43078(937) 653-1320(937) 653-1321 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Champaign Residential Services, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHAMPAIGN RESIDENTIAL SERVICES, INC. (NPI 1033264619) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Urbana, Ohio and active in the NPI registry since January 2007. The organization lists Than Johnson, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1033264619
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameCHAMPAIGN RESIDENTIAL SERVICES, INC.
Location Address1150 SCIOTO ST, SUITE 100Urbana, OH 43078-2289
Mailing AddressPo Box 29Urbana, OH 43078-0029 · (937) 653-1320 · Fax (937) 653-1321
Phone(937) 653-1320
Fax(937) 653-1321
Organization SubpartNo
Authorized OfficialThan JohnsonChief Executive Officer · (937) 653-1320
Enumeration DateJanuary 24, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1033264619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
1150 SCIOTO ST, Urbana, OH 43078
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Other Identifiers 2

Medicaid0850637OH
Other1100114OH · Waiver Billing Provider #

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARRIE HAVERKOS MSW, LSW
Social Worker
1150 SCIOTO ST, SUITE 200
URBANA, OH 43078
Champaign County (937) 652-4555
MS. RUTH EILEEN MONTGOMERY LISW-S
Counselor (Mental Health)
1150 SCIOTO ST, SUITE 200
URBANA, OH 43078
Champaign County (937) 652-4555
MRS. HUMA A BASHIR PCC-S
Counselor
1150 SCIOTO ST, STE 200
URBANA, OH 43078
Champaign County (937) 652-4555
MARK CONRAD MILLER LISW
Counselor (Mental Health)
1150 SCIOTO ST
URBANA, OH 43078
Champaign County (937) 652-4555
MRS. MELANIE ANN PARK B.A. T.O.
Social Worker (Clinical)
1150 SCIOTO ST, STE 200
URBANA, OH 43078
Champaign County (937) 652-4555
MR. JOHN L BEER MSW, LISW
Social Worker (Clinical)
1150 SCIOTO ST, SUITE 200
URBANA, OH 43078
Champaign County (937) 652-4555
MRS. COLLEEN CARVER WALLACE MS
Social Worker
1150 SCIOTO ST
URBANA, OH 43078
Champaign County (937) 652-4555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Champaign Residential Services, Inc.'s NPI number?

The NPI number for Champaign Residential Services, Inc. is 1033264619. It was assigned to this organization in the NPPES registry on January 24, 2007.

Where is Champaign Residential Services, Inc. located?

Champaign Residential Services, Inc. is located at 1150 Scioto St Suite 100, Urbana, OH 43078. The listed phone number is (937) 653-1320.

What is Champaign Residential Services, Inc.'s specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Champaign Residential Services, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.