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Organization
OCONOMOWOC DEVELOPMENTAL TRAINING CENTER OF WISCONSIN LLC
Active
Organization
OCONOMOWOC DEVELOPMENTAL TRAINING CENTER OF WISCONSIN LLC
Active
Parent organization
OCONOMOWOC DEVELOPMENTAL TRAINING CENTER OF WISCONSIN LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
OCONOMOWOC DEVELOPMENTAL TRAINING CENTER OF WISCONSIN LLC
Authorized official
MS. VICTORIA ANN RAML-GLIDER MSSW (EXECUTIVE DIRECTOR)
(262) 569-5510
Entity
Organization
Contact information
Practice address
36100 GENESEE LAKE SCHOOL, OCONOMOWOC, WI 53066
(262) 569-5510
Mailing address
36100 GENESEE LAKE SCHOOL, OCONOMOWOC, WI 53066
(262) 569-5510
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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