Provider Demographics
NPI:1871291427
Name:CHAMPAIGN COUNTY ANIMAL WELFARE LEAGUE, INC.
Entity type:Organization
Organization Name:CHAMPAIGN COUNTY ANIMAL WELFARE LEAGUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TRAJEANA
Authorized Official - Middle Name:F
Authorized Official - Last Name:FRANKS KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-834-5236
Mailing Address - Street 1:3858 STATE ROUTE 56
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43044-9647
Mailing Address - Country:US
Mailing Address - Phone:937-834-5236
Mailing Address - Fax:
Practice Address - Street 1:3858 STATE ROUTE 56
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:OH
Practice Address - Zip Code:43044-9647
Practice Address - Country:US
Practice Address - Phone:937-834-5236
Practice Address - Fax:937-834-5171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services