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CHAMPION ESTATES ASSISTED LIVING RESIDENCE
NPI 1992058663
Assisted Living Facility in Warren, OH

Active since October 18, 2012CLIA 36D2284009 · Waiver
1 WINDSOR PLACE, WARREN, OH 44483(330) 841-1555(330) 841-2244 Get Directions Write a Review

NPPES record last updated: December 31, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Champion Estates Assisted Living Residence NPPES

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

CHAMPION ESTATES ASSISTED LIVING RESIDENCE (NPI 1992058663) is a healthcare organization registered as an assisted living facility in Warren, Ohio and active in the NPI registry since October 2012. The organization holds a CLIA Waiver certificate valid through June 14, 2027 and lists John J Masternick, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1992058663
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameOMNI MANOR, INC.
Location Address1 WINDSOR PLACEWarren, OH 44483
Mailing Address101 W Liberty StGirard, OH 44420-2844 · (330) 545-1550 · Fax (330) 545-2444
Phone(330) 841-1555
Fax(330) 841-2244
Organization SubpartNo
Authorized OfficialJohn J MasternickOwner/president · (330) 545-1550
Enumeration DateOctober 18, 2012
Last NPPES UpdateDecember 31, 2012
✔ NPI 1992058663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
1 WINDSOR PLACE, Warren, OH 44483
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Other Names 1

Other NameChampion Estates Assisted Living Residence

Other Identifiers 1

Other2619ROH · Department Of Health

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2284009

Champion Estates Assisted Living · Warren, OH
Active · expires Jun 14, 2027
CLIA Number36D2284009
Laboratory TypeAssisted Living Facility
Certificate Effective DateJune 15, 2025
Certificate Expiration DateJune 14, 2027
Laboratory DirectorRenee Harshman
Laboratory Phone(330) 841-1555
Laboratory LocationChampion Estates Assisted Living1 Windsor Place, Warren, OH 44483
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Omni Manor, Inc.'s NPI number?

The NPI number for Omni Manor, Inc. is 1992058663. It was assigned to this organization in the NPPES registry on October 18, 2012. The provider is also known as Champion Estates Assisted Living Residence.

Where is Omni Manor, Inc. located?

Omni Manor, Inc. is located at 1 Windsor Place, Warren, OH 44483. The listed phone number is (330) 841-1555.

What is Omni Manor, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Omni Manor, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2284009) is associated with this NPI, valid through June 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Omni Manor, Inc. was last updated on December 31, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.