Organization
NORMIC ENTERPRISES INC
Active
Other names
My Place of Watertown
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY CARL FREMDER (VICE PRESIDENT)
(414) 962-7773
Entity
Organization
Contact information
Practice address
N8761 OVERLAND DR, WATERTOWN, WI 53094-9592
(414) 962-7773
(920) 355-0175
Mailing address
N248 COUNTY ROAD P, OCONOMOWOC, WI 53066-9506
(414) 962-7773
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/27/2017
Last updated
12/27/2017
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