NPIMap

Organization Active NPI

Buckeye Community Services, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Jackson, OH
National Provider Identifier
1003671611
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
BUCKEYE COMMUNITY SERVICES, INC.
Practice address
265 Pearl St
Jackson, OH 45640-1748
Phone
(740) 286-5039
NPI assigned
Feb 14, 2024
Last updated
Feb 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cindy J Brooks
Title
Executive Director
Phone
(740) 286-5039

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

265 Pearl St
Jackson, OH 45640-1748

Mailing address

PO Box 604
Jackson, OH 45640-0604
Phone (740) 286-5039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003671611. Details of each certification follow.

  • CCN 36G781 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G781

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BUCKEYE COMMUNITY SERVICES - PEARL STREET
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
May 1, 2024
Last certification
Mar 25, 2025
Beds
8
Ownership / control type
Private (non-profit)
Facility address
265 Pearl Street
Jackson, OH 45640

National Provider Directory

National Provider Directory
Tax ID family
Buckeye Community Services Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

265 Pearl St
Jackson, OH 45640
Phone (740) 286-5039

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1003671611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456400604",
            "telephone_number": "740-286-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 PEARL ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401748",
            "telephone_number": "740-286-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKEYE COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "740-286-5039"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, OH

Sources for this page

Verify at the official NPI Registry.