Provider Demographics
NPI:1912652876
Name:5900 WEST CHESTER OPERATING CO LLC
Entity Type:Organization
Organization Name:5900 WEST CHESTER OPERATING CO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YITZHAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-489-7100
Mailing Address - Street 1:4700 ASHWOOD DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2424
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5900 W CHESTER RD STE C
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2951
Practice Address - Country:US
Practice Address - Phone:513-777-2428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health