Healthcare Provider Details

I. General information

NPI: 1265167233
Provider Name (Legal Business Name): BUCKEYE SENIOR REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7750 PARAGON RD
DAYTON OH
45459-4050
US

IV. Provider business mailing address

7750 PARAGON RD
DAYTON OH
45459-4050
US

V. Phone/Fax

Practice location:
  • Phone: 937-291-3780
  • Fax: 937-291-3789
Mailing address:
  • Phone: 937-291-3780
  • Fax: 937-291-3789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: TINA HARDWICK
Title or Position: PRESIDENT
Credential:
Phone: 937-291-3780