Provider Demographics
NPI:1710578505
Name:BARKS AND REC
Entity Type:Organization
Organization Name:BARKS AND REC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHELEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-571-1778
Mailing Address - Street 1:1010 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2636
Mailing Address - Country:US
Mailing Address - Phone:614-725-1475
Mailing Address - Fax:
Practice Address - Street 1:1010 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2636
Practice Address - Country:US
Practice Address - Phone:614-725-1475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0364570Medicaid