Prader Willi Homes of Oconomowoc LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PRADER WILLI HOMES OF OCONOMOWOC LLC

Doing business as

Prader Willi Homes of Oconomowoc

Practice address

1746 Executive Drive
Oconomowoc, WI 53066

Phone

(262) 569-5515

NPI assigned

Jan 26, 2007

Last updated

Jul 18, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Schmieder, CPA

Title

Controller

Phone

(262) 569-5515

Specialties & licenses 1

Addresses

Other names 1

• Prader Willi Homes of Oconomowoc Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1396891875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "DOUSMAN",
            "state": "WI",
            "postal_code": "53118",
            "telephone_number": "262-569-5515",
            "fax_number": "262-569-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1746 EXECUTIVE DRIVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "53066",
            "telephone_number": "262-569-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRADER WILLI HOMES OF OCONOMOWOC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "SCHMIEDER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "262-569-5515",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prader Willi Homes of Oconomowoc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark S Polentini, MD
• Mischel Pomasl, CSW, CSAC
• Kaley Poole
• Ian R Powell, M.D.
• James Mitchell Powell, DC
• Presbyterian Homes of Wisconsin, Inc. (Presbyterian Homes and Services Rehabilitation)
• Prescription Center Pharmacy
• Randy J Prestash, OD
• Primelife Health and Wellness (PrimeLife)
• Procare Plus, LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.