Homes for Independent Living of Wisconsin LLC
NPI #1306975289 in Oconomowoc, Wisconsin
Provider Information
- NPI Number
- 1306975289
- Entity Type
- Organization
- Organization Name
- Homes for Independent Living of Wisconsin LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Mar 5, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1746 EXECUTIVE DRIVE
- City
- Oconomowoc
- State
- Wisconsin
- ZIP Code
- 53066
- Phone
- (262) 569-5515
Authorized Official
- Name
- MS. M DEBORAH FRISK, MSW
- Title
- VICE PRESIDENT
- Phone
- (262) 569-5515
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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