OCONOMOWOC DEVELOPMENTAL TRAINING CENTER OF WISCONSIN LLC (NPI# 1689145500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689145500 |
| Entity Type | Organization |
| Organization Name | OCONOMOWOC DEVELOPMENTAL TRAINING CENTER OF WISCONSIN LLC |
| Practice Address |
36100 Genesee Lake School Oconomowoc WI 53066 |
| Practice Telephone | 2625695510 |
| Mailing Telephone | 2625695510 |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |
| Authorized Official Name | MS. VICTORIA ANN RAML-GLIDER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2625695510 |
| Authorized Official Credential | MSSW |
| Is Organization Subpart | Y |
| Parent Organization Name | OCONOMOWOC DEVELOPMENTAL TRAINING CENTER OF WISCONSIN LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720117583 | Oconomowoc Developmental Training Center of Wisconsin LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 36100 Genesee Lake Rd, Oconomowoc, WI 53066 | 2007-03-05 |
| Street Address |
36100 GENESEE LAKE SCHOOL |
| City | OCONOMOWOC |
| State | WI |
| Zip Code | 53066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376109082 | Sharon Legwinski | Occupational Therapist | 2195 N. Summit Way, Oconomowoc, WI 53066 | 2019-05-17 |
| 1033676390 | Paladina Health, LLC | Family Medicine | Paladina Health Oconomowoc Sentry Equipment Circle, 966 Blue Ribbon Circle N, Oconomowoc, WI 53066 | 2019-02-22 |
| 1649748203 | Ginny Dacquisto | Dietitian, Registered | 1134 Lily Rd, Oconomowoc, WI 53066 | 2018-11-12 |
| 1174000764 | Aimee M Metzger | Social Worker | 405 E Forest St Ste 113, Oconomowoc, WI 53066 | 2018-07-26 |
| 1023482569 | Forefront Dermatology, S.c. | Dermatology | 1320 Pabst Farms Cir, Suite 180, Oconomowoc, WI 53066 | 2015-11-20 |
| 1962890475 | Monica Rodriguez | Counselor | 405 East Forest Street, Suite 119, Oconomowoc, WI 53066 | 2015-01-06 |
| 1518384643 | Kimberley Bevan | Pharmacist | 1284 East Summit Avenue, Suite 100, Oconomowoc, WI 53066 | 2014-03-26 |
| 1699098905 | Heidi Eckroth Nunnemacher | Counselor | 35315 Genesee Lake Road, Oconomowoc, WI 53066 | 2010-03-02 |
| 1669705240 | Oconomowoc Development Training Center Ll | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3222 N. Silver Cedar Rd., Oconomowoc, WI 53066 | 2009-09-14 |
| 1538306378 | Avolen, LLC | Massage Therapist | 206 S. Silver Lake St., Oconomowoc, WI 53066 | 2009-01-15 |
| Find all providers in zip 53066 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134764103 | Anders Developmental & Transition Home LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3359 N 25th St, Milwaukee, WI 53206-1237 | 2019-11-13 |
| 1033417670 | Allendale Association | Residential Treatment Facility, Emotionally Disturbed Children | 12603 224th Ave, Benet Lake, WI 53102-1000 | 2011-03-07 |
| 1366601718 | Mercy Assisted Care Inc | Residential Treatment Facility, Emotionally Disturbed Children | 20 E Court St, Janesville, WI 53545-3976 | 2008-06-02 |
| 1346415445 | Carmelite Home, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1214 Kavanaugh Pl, Wauwatosa, WI 53213-2506 | 2008-04-29 |
| 1861666943 | Tomorrow's Children, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | N3066 Tomorrow's Lane, Waupaca, WI 54981-0192 | 2008-04-18 |
| 1629261086 | Willowglen Academy - Howard | Residential Treatment Facility, Emotionally Disturbed Children | 3959 S 51st St, Milwaukee, WI 53220-2653 | 2007-08-20 |
| 1093908451 | Willowglen Academy - Wilson | Residential Treatment Facility, Emotionally Disturbed Children | 3603 S Business Dr, Sheboygan, WI 53081-7096 | 2007-08-20 |
| 1669670477 | Willowglen Academy-wisconsin, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1111 Reed St, Plymouth, WI 53073-2506 | 2007-07-03 |
| 1457559262 | Willowglen Hein Foster Care Group Home | Residential Treatment Facility, Emotionally Disturbed Children | 207 Hein Ave, Plymouth, WI 53073-2526 | 2007-07-03 |
| 1134327943 | Bell Therapy, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 3018 S 9th St, Milwaukee, WI 53215-3944 | 2007-07-03 |
| Find all providers with the same taxonomy | ||||
| City | OCONOMOWOC |
| Zip Code | 53066 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.