Provider Demographics
NPI:1922766039
Name:BUCKEYE FOREST AT FAIRFIELD LLC
Entity Type:Organization
Organization Name:BUCKEYE FOREST AT FAIRFIELD LLC
Other - Org Name:AYDEN HEALTHCARE OF FAIRFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABBA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-874-9933
Mailing Address - Street 1:3801 WOODRIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-3598
Mailing Address - Country:US
Mailing Address - Phone:513-874-9933
Mailing Address - Fax:513-865-8989
Practice Address - Street 1:3801 WOODRIDGE BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-3598
Practice Address - Country:US
Practice Address - Phone:513-874-9933
Practice Address - Fax:513-865-8989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility