OCONOMOWOC DEVELOPMENT TRAINING CENTER LL (NPI# 1669705240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669705240 |
| Entity Type | Organization |
| Organization Name | OCONOMOWOC DEVELOPMENT TRAINING CENTER LL |
| Other Organization Name | CHERYL HOUSE GROUP HOME |
| Practice Address |
3222 N. Silver Cedar Rd. Oconomowoc WI 53066 |
| Mailing Address |
Po Box 278 Dousman WI 53118 |
| Practice Telephone | 2625695515 |
| Practice Fax Number | 2625699962 |
| Mailing Telephone | 2625695515 |
| Mailing Fax Number | 2625699962 |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |
| Authorized Official Name | MS. M. DEBORAH FRISK (VICE PRESIDENT) |
| Authorized Official Telephone | 2625695515 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | Y |
| Parent Organization Name | OCONOMOWOC DEVELOPMENT TRAINING CENTER LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | WI | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Cheryl House Group Home | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386977965 | Oconomowoc Development Training Center Ll | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 307 Wilson Ave., Dousman, WI 53118 | 2009-09-14 |
| Street Address |
3222 N. SILVER CEDAR RD. |
| 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 |
| 1689145500 | Oconomowoc Developmental Training Center of Wisconsin LLC | Residential Treatment Facility, Emotionally Disturbed Children | 36100 Genesee Lake School, Oconomowoc, WI 53066 | 2018-12-17 |
| 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 |
| 1538306378 | Avolen, LLC | Massage Therapist | 206 S. Silver Lake St., Oconomowoc, WI 53066 | 2009-01-15 |
| Find all providers in zip 53066 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093252140 | Apria Residential Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2833 S 12th St, Sheboygan, WI 53081-6703 | 2017-01-27 |
| 1316482920 | Cheryl Mcmahon | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2483 28th St, Rice Lake, WI 54868-9098 | 2017-01-05 |
| 1093174765 | Diane Cook | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 12489 State Highway 56, Viola, WI 54664-8914 | 2016-02-23 |
| 1467810788 | Stonebrick Residential Living Facility LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4703 W Villard Ave, Milwaukee, WI 53218-4459 | 2016-02-01 |
| 1932574670 | Gayle Millis | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3260 E Carollton Dr, Oak Creek, WI 53154-4165 | 2015-12-07 |
| 1942605670 | Methu Adult Family Care Home II | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2824 N 59th St, Milwaukee, WI 53210-1504 | 2014-10-23 |
| 1720498736 | Kaiser Adult Family Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | W782 Leroy St, Edgar, WI 54426-9627 | 2014-04-29 |
| 1851721344 | Evergreen Pines Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 343 E Cumberland St, Berlin, WI 54923-1206 | 2013-11-19 |
| 1679913487 | Berlin Pines, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 642 Broadway, Berlin, WI 54923-1302 | 2013-06-26 |
| 1245502053 | Gloria Aweke | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1111 Gas Light Dr, Sun Prairie, WI 53590-3459 | 2012-02-08 |
| 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.