Provider Demographics
NPI:1740244284
Name:OESTERLEN SERVICES FOR YOUTH, INC.
Entity Type:Organization
Organization Name:OESTERLEN SERVICES FOR YOUTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:ACSW, LISW, CSWM
Authorized Official - Phone:937-399-6101
Mailing Address - Street 1:1918 MECHANICSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-3147
Mailing Address - Country:US
Mailing Address - Phone:937-399-6101
Mailing Address - Fax:937-399-6609
Practice Address - Street 1:1918 MECHANICSBURG RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-3147
Practice Address - Country:US
Practice Address - Phone:937-399-6101
Practice Address - Fax:937-399-6609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QM0855X
OH05-1327322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Not Answered322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10650OtherMENTAL HEALTH