Organization
BUCKEYE BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANGA R THALLURI MD (PSYCHIATRY)
(330) 829-9389
Entity
Organization
Contact information
Practice address
4888 ARMANDALE AVE NW, CANTON, OH 44718-2284
(330) 829-9389
(330) 829-9372
Mailing address
PO BOX 2779, ALLIANCE, OH 44601-0779
(330) 829-9389
(330) 829-9372
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35062816
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0987106
—
OH
Enumeration date
06/16/2008
Last updated
12/09/2010
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