Healthcare Provider Details

I. General information

NPI: 1063565414
Provider Name (Legal Business Name): TODDS COMPANION PLUS OF IN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 RAMBLIN CT
GREENWOOD IN
46142-8344
US

IV. Provider business mailing address

1111 RAMBLIN COURT
GREENWOOD IN
46142-8344
US

V. Phone/Fax

Practice location:
  • Phone: 317-885-7337
  • Fax: 262-842-0199
Mailing address:
  • Phone: 317-885-7337
  • Fax: 262-842-0199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARON TODD WILSON
Title or Position: CO OWNER DIRECTOR
Credential: ADMINISTRATION CNA
Phone: 317-885-7337