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Organization

OJ SUPPORT LIVING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OUSMAN JATTA CEO (MANAGING MEMBER)
(937) 658-8754
Entity
Organization

Contact information

Practice address
410 W PARKWOOD ST, SIDNEY, OH 45365-3612
(937) 409-8633
Mailing address
410 W PARKWOOD ST, SIDNEY, OH 45365-3612
(937) 409-8633

Taxonomy

Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary

Other

Enumeration date
04/23/2026
Last updated
04/23/2026
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