Provider Demographics
NPI:1295516664
Name:ON THE FARM
Entity type:Organization
Organization Name:ON THE FARM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FULEKI
Authorized Official - Suffix:
Authorized Official - Credentials:ADULT DAY SERVICES
Authorized Official - Phone:740-621-0209
Mailing Address - Street 1:6511 WINEGARDNER RD NW
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43150-9605
Mailing Address - Country:US
Mailing Address - Phone:740-621-0209
Mailing Address - Fax:
Practice Address - Street 1:6511 WINEGARDNER RD NW
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:OH
Practice Address - Zip Code:43150-9605
Practice Address - Country:US
Practice Address - Phone:740-621-0209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services