| Opportunity Development Centers, Inc. | |
|
1191 Huntington Ave Wisconsin Rapids WI 54494-6364 | |
| (715) 424-2750 | |
| Not Available |
| Full Name | Opportunity Development Centers, Inc. |
|---|---|
| Speciality | Day Training, Developmentally Disabled Services |
| Location | 1191 Huntington Ave, Wisconsin Rapids, Wisconsin |
| Authorized Official Name and Position | Kathryn Anne Haupt (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 7158186443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Opportunity Development Centers, Inc. 1191 Huntington Ave Wisconsin Rapids WI 54494-6364 Ph: (715) 424-2750 | Opportunity Development Centers, Inc. 1191 Huntington Ave Wisconsin Rapids WI 54494-6364 Ph: (715) 424-2750 |
| NPI Number | 1013161587 |
|---|---|
| Provider Enumeration Date | 11/11/2008 |
| Last Update Date | 03/06/2025 |
| Certification Date | 03/06/2025 |
| Medicare PECOS PAC ID | 6901263912 |
|---|---|
| Medicare Enrollment ID | O20230607001040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013161587 | NPI | - | NPPES |
| Provider Name | Kathryn Haupt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730308040 PECOS PAC ID: 8022319615 Enrollment ID: I20151228000946 |
| Provider Name | Jeremy Vern Woodliff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316616592 PECOS PAC ID: 2062942139 Enrollment ID: I20250214002726 |
| Provider Name | Lakyn Lloyd |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497352348 PECOS PAC ID: 8426588302 Enrollment ID: I20250306002299 |
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