Healthcare Provider Details

I. General information

NPI: 1205471281
Provider Name (Legal Business Name): COMPANION DAY SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 TINY TIGERS CT
MARSHFIELD WI
54449-3069
US

IV. Provider business mailing address

905 TINY TIGERS CT
MARSHFIELD WI
54449-3069
US

V. Phone/Fax

Practice location:
  • Phone: 715-384-2115
  • Fax:
Mailing address:
  • Phone: 715-384-2115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: SUSAN BABCOCK
Title or Position: BOARD TREASURER
Credential:
Phone: 715-384-2115