Healthcare Provider Details

I. General information

NPI: 1790940427
Provider Name (Legal Business Name): BUCKEYE ADULT DAYCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2643 NORTHLAND PLAZA DR
COLUMBUS OH
43231-4052
US

IV. Provider business mailing address

2643 NORTHLAND PLAZA DR
COLUMBUS OH
43231-4052
US

V. Phone/Fax

Practice location:
  • Phone: 614-845-7694
  • Fax: 614-882-6296
Mailing address:
  • Phone: 614-845-7694
  • Fax: 614-882-6296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number2861336
License Number StateOH

VIII. Authorized Official

Name: MR. ABDIWELI M SHEIKHDON
Title or Position: CEO
Credential:
Phone: 614-370-8044