Provider Demographics
NPI:1447088281
Name:OSL SCHOFIELD OPERATING LLC
Entity type:Organization
Organization Name:OSL SCHOFIELD OPERATING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:414-324-5172
Mailing Address - Street 1:2448 S 102ND ST STE 305
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2141
Mailing Address - Country:US
Mailing Address - Phone:414-214-8950
Mailing Address - Fax:414-755-1315
Practice Address - Street 1:1404 LILI LN
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-4941
Practice Address - Country:US
Practice Address - Phone:715-355-0586
Practice Address - Fax:715-355-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility