Healthcare Provider Details

I. General information

NPI: 1194541557
Provider Name (Legal Business Name): JADA FARTHING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

569 TECUMSEH ST
TOLEDO OH
43604-8531
US

IV. Provider business mailing address

1205 LOUISIANA AVE # 851
PERRYSBURG OH
43551-2354
US

V. Phone/Fax

Practice location:
  • Phone: 419-461-6952
  • Fax:
Mailing address:
  • Phone: 419-461-6952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: