MEDICARE: TODD'S COMPANIONPLUS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	1042	WI

General Provider Information

NPI Number	:	1669479556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TODD'S COMPANIONPLUS, INC.

Provider Business Mailing Address
First Line	:	6123 GREEN BAY RD
Second Line	:	SUITE 230
City	:	KENOSHA
State	:	WI
Zip	:	53142-2927
Country	:	US
Telephone Number	:	262-842-0405
Fax Number	:	262-842-0075

Provider Business Practice Location Address
First Line	:	6123 GREEN BAY RD
Second Line	:	SUITE 230
City	:	KENOSHA
State	:	WI
Zip	:	53142-2927
Country	:	US
Telephone Number	:	262-842-0405
Fax Number	:	262-842-0075

Authorized Official
Title or Position	:	OWNER
Name	:	MR. WILLIAM B. TODD
Credential	:
Telephone Number	:	262-842-0405

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/22/2020

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