MEDICARE: OSL PLATINUM OPERATING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1689526766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSL PLATINUM OPERATING LLC

Provider Business Mailing Address
First Line	:	2448 S 102ND ST STE 305
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53227-2141
Country	:	US
Telephone Number	:	414-214-8991
Fax Number	:	262-364-2794

Provider Business Practice Location Address
First Line	:	2448 S 102ND ST STE 305
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53227-2141
Country	:	US
Telephone Number	:	414-214-8991
Fax Number	:	262-364-2794

Authorized Official
Title or Position	:	VP
Name	:	MATT TERESINSKI
Credential	:
Telephone Number	:	414-617-6337

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “OSL PLATINUM OPERATING LLC ” Practice Location

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