Healthcare Provider Details

I. General information

NPI: 1093626913
Provider Name (Legal Business Name): FAIRFIELD OSL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6131 E RIVER RD
FAIRFIELD OH
45014-3241
US

IV. Provider business mailing address

PO BOX 75
MONROE OH
45050-0075
US

V. Phone/Fax

Practice location:
  • Phone: 513-701-9218
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY METTLER
Title or Position: DIRECTOR OF OPERATIONS
Credential: RN
Phone: 937-561-2048