Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Oconomowoc Developmental Training Center of Wisconsin LLC

Organization Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1720117583

Oconomowoc Developmental Training Center of Wisconsin LLC is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Oconomowoc, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.

Licensed in
WI
In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

36100 Genesee Lake Rd
Oconomowoc, WI 53066
Phone: (262) 569-5515
Fax: (262) 569-9962
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) Taxonomy 320600000X (WI)

Record details

NPI number1720117583
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official M Frisk — Vice President · (262) 569-5515
Other names Oconomowoc Developmental Training Center Odtc
NPI enumeratedMarch 5, 2007
Last updated in NPPESAugust 22, 2020
Mailing addressPo Box 278, Dousman, WI 53118

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