Healthcare Provider Details

I. General information

NPI: 1467788786
Provider Name (Legal Business Name): TODD STEVEN & ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 ALGOMA BLVD
OSHKOSH WI
54901-4775
US

IV. Provider business mailing address

240 ALGOMA BLVD
OSHKOSH WI
54901-4775
US

V. Phone/Fax

Practice location:
  • Phone: 920-232-3649
  • Fax:
Mailing address:
  • Phone: 920-232-3649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateWI

VIII. Authorized Official

Name: MR. TODD JEROMY KLAUER
Title or Position: VICE PRESIDENT OF PROGRAMS
Credential:
Phone: 920-232-3649