Provider Demographics
NPI:1871852582
Name:THE BUCKEYE RANCH, INC
Entity Type:Organization
Organization Name:THE BUCKEYE RANCH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR CREDENTIALING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-396-6395
Mailing Address - Street 1:5665 HOOVER ROAD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123
Mailing Address - Country:US
Mailing Address - Phone:614-875-2371
Mailing Address - Fax:614-875-2366
Practice Address - Street 1:5665 HOOVER RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9122
Practice Address - Country:US
Practice Address - Phone:614-384-7798
Practice Address - Fax:614-384-7798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-15
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12433261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3153/12433OtherSTATE OF OHIO MACIL UPI #
OH2863718OtherOHIO MITS PROVIDER ID