Oconomowoc Developmental Training Center of Wisconsin LLC
NPI #1689145500 in Oconomowoc, Wisconsin
Provider Information
- NPI Number
- 1689145500
- Entity Type
- Organization
- Organization Name
- Oconomowoc Developmental Training Center of Wisconsin LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- OCONOMOWOC DEVELOPMENTAL TRAINING CENTER OF WISCONSIN LLC
- Primary Specialty
- Residential Treatment Facility, Emotionally Disturbed Children
- Enumeration Date
- Dec 17, 2018
- Last Updated
- Dec 17, 2018
Practice Location
- Address
- 36100 GENESEE LAKE SCHOOL
- City
- Oconomowoc
- State
- Wisconsin
- ZIP Code
- 53066
- Phone
- (262) 569-5510
Authorized Official
- Name
- MS. VICTORIA ANN RAML-GLIDER, MSSW
- Title
- EXECUTIVE DIRECTOR
- Phone
- (262) 569-5510
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Emotionally Disturbed Children |
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