Oconomowoc Development Training Center LL
Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Dousman, WI
NPI 1386977965 · NPPES record last updated Sep 14, 2009
Key facts
- NPI
- 1386977965
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
- Legal business name
- OCONOMOWOC DEVELOPMENT TRAINING CENTER LL
- Practice address
- 307 Wilson Ave.
Dousman, WI 53118 - Phone
- (262) 569-5515
- Fax
- (262) 569-9962
- NPI assigned
- Sep 14, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- OCONOMOWOC DEVELOPMENT TRAINING CENTER LLC
Authorized official
- Name
- Ms. M. Deborah Frisk, MSW
- Title
- Vice President
- Phone
- (262) 569-5515
Corporate family (same tax ID) 4
National Provider Directory
- Tax ID family
- Oconomowoc Developmental Training Center of Wisconsin LLC
- Part of
- Oconomowoc Developmental Training Center of Wisconsin LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | WI | Yes |
Addresses
Primary practice location
307 Wilson Ave.
Dousman, WI 53118
Mailing address
PO Box 278
Dousman, WI 53118
Phone (262) 569-5515
Other names
- Sawyer House Group Home
Other providers in Dousman, WI
- Debra Makinen
- Judy Rene Martinez
- Masonic Center for Health and Rehab Inc.
- Aaron Tyler Moore
- Dennis James Neuenfeldt
- Oconomowoc Devemopmental Training Center LL
- Kathleen Ann Papa
- Nicholas Eli Pecoraro
- Wendy Jean Peters
- Rose Rawson
All providers in Dousman, WI · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.