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General NPI Number Information
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NPI Number | 1730039199
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Entity Type | Organization
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Legal Business Name | JACOBS LADDER TO RECOVERY
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 599 W MAIN ST
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City | GENEVA
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State | OH
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Zip | 44041-1252
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Country | US
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Telephone | 740-709-2210
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Fax |
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Provider Business Mailing Address
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Address Line | 307 4TH ST E APT 1A
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City | SOUTH POINT
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State | OH
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Zip | 45680-8456
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DAVID GRAVES
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Credential |
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Telephone | 740-709-2210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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