Osl 1301 Watertown Operating LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

OSL 1301 WATERTOWN OPERATING LLC

Practice address

1301 E Main St
Watertown, WI 53094-4043

Phone

(920) 567-0100

Fax

(920) 567-0101

NPI assigned

Aug 31, 2023

Last updated

Jul 23, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

OSL PLATINUM MANAGEMENT LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matt Teresinski

Title

VP

Phone

(414) 324-5172

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1831974393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 S 102ND ST STE 305",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272141",
            "telephone_number": "414-214-8950",
            "fax_number": "414-755-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E MAIN ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530944043",
            "telephone_number": "920-567-0100",
            "fax_number": "920-567-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSL 1301 WATERTOWN OPERATING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSL PLATINUM MANAGEMENT LLC",
        "enumeration_date": "2023-08-31",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "TERESINSKI",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "414-324-5172"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.