IndividualActive
David Jacobus
NPI 1174071153 · Substance Abuse Rehabilitation Facility · Ontario, OR
Provider details
- NPI number
- 1174071153
- Entity type
- Individual
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
686 Nw 9th St
Ontario, OR 97914-1600
Phone: (541) 889-9167
Approximate (ZIP-level) locationGet directions
Mailing address
702 Sunset Dr
Ontario, OR 97914-3121
Registry dates
- Enumerated
- 2016-09-19
- Last updated
- 2016-09-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.