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NPI Code Detail

MEDICARE: THE BUCKEYE RANCH, INC

MEDICARE: THE BUCKEYE RANCH, INC
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
1323P00000XPsychiatric Residential Treatment Facility1469, 1642OH
23245S0500XChildren's Substance Abuse Rehabilitation Facility03153OH
3385HR2055XChild Mental Illness Respite Care1642OH
4261QM0855XAdolescent and Children Mental Health Clinic/Center0153OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12864235OTHEROHOHIO MITS PROVIDER
23153OTHEROHMACSIS UPI

General Provider Information

NPI Number : 1649230236
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE BUCKEYE RANCH, INC
Provider Business Mailing Address
First Line : 4653 E MAIN ST
Second Line :
City : WHITEHALL
State : OH
Zip : 43213-3298
Country : US
Telephone Number : 614-384-7798
Fax Number : 614-384-7703
Provider Business Practice Location Address
First Line : 4653 E MAIN ST
Second Line :
City : WHITEHALL
State : OH
Zip : 43213-3298
Country : US
Telephone Number : 614-384-7798
Fax Number : 614-384-7703
Authorized Official
Title or Position : HR CREDENTIALING SPECIALIST
Name : LEIGH ANN TURNER
Credential :
Telephone Number : 614-539-6639
Provider Enumeration Date : 03/27/2006
Last Update Date : 10/25/2022

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Directions to “THE BUCKEYE RANCH, INC ” Practice Location

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