Healthcare Provider Details

I. General information

NPI: 1780530048
Provider Name (Legal Business Name): WOODMAN KIDS OPERATING CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10123 ALLIANCE RD
BLUE ASH OH
45242-4887
US

IV. Provider business mailing address

10123 ALLIANCE RD
BLUE ASH OH
45242-4887
US

V. Phone/Fax

Practice location:
  • Phone: 513-530-1808
  • Fax:
Mailing address:
  • Phone: 513-530-1808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: YITZCHAK ROSEDALE
Title or Position: PRESIDENT
Credential:
Phone: 513-530-1808