Organization
BUCKEYE FAMILY SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANITA JONES (CEO)
(234) 804-4060
Entity
Organization
Contact information
Practice address
2415 20TH ST NE, CANTON, OH 44705-2405
(234) 804-4060
Mailing address
2415 20TH ST NE, CANTON, OH 44705-2405
(234) 804-4060
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
311ZA0620X
Adult Care Home Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
332U00000X
Home Delivered Meals
—
—
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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