John C Blake
John C Blake is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oshkosh, Wisconsin. Practices as a sole proprietor and works from 2 locations. Licensed in Wisconsin.
- Licensed in
- WI
- In the registry since
- 2025
Practice location Address checks out
50 Pearl Ave Ste 102Oshkosh, WI 54901-4811
Phone: (414) 345-7781
Fax: (866) 496-2680
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 2323 Lake Club Dr Ste 301, Columbus, OH 43232-3198 — (614) 456-4999
Specialties & licences
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) | Taxonomy 320900000X · Licence 0017165 (WI) |
|---|
Record details
| NPI number | 1134924475 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | February 19, 2025 |
| Last updated in NPPES | February 19, 2025 |
| Certification date | February 19, 2025 |
| Mailing address | 2844 Montclair Pl, Oshkosh, WI 54904-8944 |