Organization
INDIANA DEVELOPMENTAL TRAINING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. M DEBORAH FRISK MSW (VICE PRESIDENT)
(262) 569-5515
Entity
Organization
Contact information
Practice address
11075 N PENNSYLVANIA ST, INDIANAPOLIS, IN 46280
(317) 815-0505
(317) 815-1645
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
—
IN
Other
Enumeration date
03/05/2007
Last updated
08/22/2020
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