50 St Lawrence Opco LLC
Organization Active NPI Psychiatric Hospital · Tiffin, OH
NPI 1699519199 · NPPES record last updated Sep 23, 2025
Key facts
- NPI
- 1699519199
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital 283Q00000X
- Legal business name
- 50 ST LAWRENCE OPCO LLC
- Practice address
- 50 St Lawrence Dr
Tiffin, OH 44883-8310 - Phone
- (567) 207-2230
- NPI assigned
- Jun 20, 2024
- Organization subpart
- No
Authorized official
- Name
- Daniel Schaffer
- Title
- Managing Member
- Phone
- (347) 728-8425
Owners & managing parties with NPI records 1
-
Irfan Ahmed, MD
Facilities with the same owner 27
Practitioners 1
-
Irfan Ahmed, MD
Medicare Care Compare: Hospital
- Listed as
- Sojourn at Seneca Senior Behavioral Health Hospita
- Type
- Psychiatric
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Hospital certification: CCN 364055
- Legal name
- 50 ST LAWRENCE OPCO LLC
- Doing business as
- SOJOURN AT SENECA SENIOR BEHAVIORAL HEALTH HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- May 13, 2016
- Last certification
- May 13, 2016
- Beds
- 24
- Ownership / control type
- Private (not for profit)
- Most recent change of ownership
- Jun 20, 2024 (1 total)
- Organization structure
- LLC · Proprietary
- Enrollment address
- 50 St Lawrence Dr
Tiffin, OH 44883-8310 - Hospital subgroups
- Psychiatric
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Avi Philipson |
5% Or Greater Indirect Ownership Interest | Jun 20, 2024 | 8% |
| Agrp 2011 Trust |
5% Or Greater Indirect Ownership Interest | Jun 20, 2024 | 8% |
| Patricia Huber |
W-2 Managing Employee |
Jun 20, 2024 | |
| Ohtree Sojourn Opco Holdco LLC |
5% Or Greater Direct Ownership Interest | Jun 20, 2024 | 100% |
| Irfan Ahmed |
W-2 Managing Employee |
Jun 20, 2024 | |
| Vicki Drazin |
5% Or Greater Indirect Ownership Interest | Jun 20, 2024 | 8% |
| Rap 118 LLC |
5% Or Greater Indirect Ownership Interest | Jun 20, 2024 | 16.25% |
| Deborah Philipson 2011 Family Trust |
5% Or Greater Indirect Ownership Interest | Jun 20, 2024 | 8% |
| Matis Mark Friedman |
5% Or Greater Indirect Ownership Interest | Jun 20, 2024 | 10% |
| Philipson Family Limited Liability Company, LLC |
5% Or Greater Indirect Ownership Interest | Jun 20, 2024 | 16.25% |
| Daniel Schaffer |
5% Or Greater Indirect Ownership Interest | Jun 20, 2024 | 7.5% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241204001406 | OH | Part a Provider - Hospital | 4183150931 | Practice locations: Tiffin, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | Yes | ||
| Substance Abuse Rehabilitation Facility | 324500000X |
Addresses
Primary practice location
50 St Lawrence Dr
Tiffin, OH 44883-8310
Mailing address
60 Hempstead Ave Ste 3005
West Hempstead, NY 11552-2148
Phone (347) 728-8425
Other providers in Tiffin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.