| Jacobus Family Enterprises Llc | |
|
728 Harvest Ln Washington Township OH 45458-4359 | |
| (219) 765-3216 | |
| Not Available |
| Full Name | Jacobus Family Enterprises Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 728 Harvest Ln, Washington Township, Ohio |
| Authorized Official Name and Position | Brent Jacobus (MEMBER) |
| Authorized Official Contact | 2197653216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacobus Family Enterprises Llc 728 Harvest Ln Washington Township OH 45458-4359 Ph: (219) 765-3216 | Jacobus Family Enterprises Llc 728 Harvest Ln Washington Township OH 45458-4359 Ph: (219) 765-3216 |
| NPI Number | 1861274979 |
|---|---|
| Provider Enumeration Date | 10/16/2023 |
| Last Update Date | 10/16/2023 |
| Certification Date | 10/15/2023 |
| Medicare PECOS PAC ID | 1052750379 |
|---|---|
| Medicare Enrollment ID | O20240419001389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861274979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084S0012X | Psychiatry & Neurology - Sleep Medicine | (* (Not Available)) | Primary |
| Provider Name | Brent Jacobus |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447757406 PECOS PAC ID: 7315360401 Enrollment ID: I20240419001483 |
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