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General NPI Number Information
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NPI Number | 1285279562
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Entity Type | Individual
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Provider Name | JARED SLOAN LADAC, CADAC, NCAC I
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Gender | Male
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Dates
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Enumeration Date | 11/11/2019
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 107 S DALMONT ST
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City | HOBBS
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State | NM
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Zip | 88240-8428
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Country | US
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Telephone | 575-391-1301
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Fax | 575-391-1303
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Provider Business Mailing Address
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Address Line | PO BOX 5403
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City | HOBBS
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State | NM
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Zip | 88241-5403
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Country | US
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Telephone | 575-391-1301
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Fax | 575-391-1303
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0108681
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License Number State | NM
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