OrganizationActive
Oconomowoc Developmental Training Center of Wisconsin LLC
NPI 1720117583 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Oconomowoc, WI
Provider details
- NPI number
- 1720117583
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- M Frisk, Vice President(262) 569-5515
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
36100 Genesee Lake Rd
Oconomowoc, WI 53066
Phone: (262) 569-5515
Fax: (262) 569-9962
Street-level locationGet directions
Mailing address
Po Box 278
Dousman, WI 53118
Other names (DBA / former)
- Doing business as
- Oconomowoc Developmental Training Center Odtc
Registry dates
- Enumerated
- 2007-03-05
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.