NPI 1114056074

Indiana Developmental Training Center of Lafayette LLC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Lafayette, IN

Practice location

Address: 3700 Rome Drive, Lafayette, IN 47905
Phone: (765) 448-4220
Fax: (765) 488-4217
Mailing address: PO Box 278, Dousman, WI 53118

Authorised official

Name: M Deborah Frisk
Title: Vice President
Phone: (262) 569-5515

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1114056074
Entity type: Organization
NPI issued: 5 Mar 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.