Provider Demographics
NPI:1023615721
Name:BUCKEYE RESIDENTIAL SOLUTIONS LLC
Entity type:Organization
Organization Name:BUCKEYE RESIDENTIAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-235-9183
Mailing Address - Street 1:320 E MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3102
Mailing Address - Country:US
Mailing Address - Phone:330-235-9183
Mailing Address - Fax:330-297-9725
Practice Address - Street 1:320 E MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3102
Practice Address - Country:US
Practice Address - Phone:330-235-9183
Practice Address - Fax:330-297-9725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6703820Medicaid