Organization
OCONOMOWOC DEVEMOPMENTAL TRAINING CENTER LL
Active
Parent organization
OCONOMOWOC DEVEMOPMENTAL TRAINING CENTER LLC
Other names
Cory House Group Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
OCONOMOWOC DEVEMOPMENTAL TRAINING CENTER LLC
Authorized official
MS. M. DEBORAH FRISK MSW (VICE PRESIDENT)
(262) 569-5515
Entity
Organization
Contact information
Practice address
201-203 CORY AVE., DOUSMAN, WI 53118
(262) 569-5515
(262) 569-9962
Mailing address
PO BOX 278, DOUSMAN, WI 53118
(262) 569-5515
(262) 569-9962
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
WI
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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