Jacob's Ladder at Brookside Farm, LLC
NPI #1205344355 in Aurora, West Virginia
Provider Information
- NPI Number
- 1205344355
- Entity Type
- Organization
- Organization Name
- Jacob's Ladder at Brookside Farm, LLC
- Primary Specialty
- Clinic/Center - Rehabilitation, Substance Use Disorder
- Enumeration Date
- Jan 10, 2018
- Last Updated
- Jan 10, 2018
Practice Location
- Address
- 25208 GEORGE WASHINGTON HWY
- City
- Aurora
- State
- West Virginia
- ZIP Code
- 26705-8036
- Phone
- (304) 239-1214
Authorized Official
- Name
- DR. KEVIN BLANKENSHIP, MD
- Title
- CEO
- Phone
- (304) 290-0000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
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