NPI | 1679266126 |
---|---|
Doing Business As | CHAMPION WELLNESS SERVICE, INC. |
Entity Type | Organization |
Authorized Contact | SHNARIKA SIMONE POWELL Pmhnp 706-489-4719 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2023-05-31 |
Last Update Date | 2024-06-24 |