Healthcare Provider Details

I. General information

NPI: 1366107385
Provider Name (Legal Business Name): BUCKEYE FOREST AT GREENVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2021
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 MARION DR
GREENVILLE OH
45331-2613
US

IV. Provider business mailing address

5910 LANDERBROOK DR STE 150
MAYFIELD HEIGHTS OH
44124-6506
US

V. Phone/Fax

Practice location:
  • Phone: 937-548-3141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JEFF DEGYANSKY
Title or Position: COO
Credential:
Phone: 330-620-7828