PRADER WILLI HOMES OF OCONOMOWOC – NPI #1396891875
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

PRADER WILLI HOMES OF OCONOMOWOC is a community based residential treatment facility located in OCONOMOWOC, WI. NPPES has assigned the NPI number 1396891875 to PRADER WILLI HOMES OF OCONOMOWOC on January 26, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PRADER WILLI HOMES OF OCONOMOWOC” is a dba name, the actual legal business name for this organization is PRADER WILLI HOMES OF OCONOMOWOC LLC. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was last updated on Jul 18, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PRADER WILLI HOMES OF OCONOMOWOC below.

NPI Profile for
PRADER WILLI HOMES OF OCONOMOWOC LLC

NPI Number
1396891875
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRADER WILLI HOMES OF OCONOMOWOC LLC
Doing Business As (dba): PRADER WILLI HOMES OF OCONOMOWOC
Primary location
1746 EXECUTIVE DRIVE
OCONOMOWOC, WI 53066
Phone: (262) 569-5515 Fax:
Mailing address
PO BOX 278
DOUSMAN, WI 53118
Phone: (262) 569-5515 Fax: (262) 569-9962
Organization Subpart
No
Authorized Official
MELISSA SCHMIEDER
CONTROLLER
Phone: (262) 569-5515
Updated
Certification Date
Jul 18, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.