JACOB'S LADDER AT BROOKSIDE FARM, LLC
NPI 1205344355
Clinic/Center - Rehabilitation, Substance Use Disorder in Aurora, WV

NPI Status: Active since January 10, 2018

Contact Information

25208 GEORGE WASHINGTON HWY
AURORA, WV
ZIP 26705
Phone: (304) 239-1214

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  • Organization
  • Clinic/Center
  • Rehabilitation, Substance Use Disorder
  • CLIA Number: 51D2145661
  • CLIA Cert. Type: Other - INPATIENT ADDICTION TREAT
  • CLIA Exp. Date: 03-12-2028

About JACOB'S LADDER AT BROOKSIDE FARM, LLC

This page provides the complete NPI Profile along with additional information for Jacob's Ladder At Brookside Farm, Llc, a provider established in Aurora, West Virginia operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1205344355 assigned on January 2018. The practitioner's primary taxonomy code is 261QR0405X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The authorized official of this NPI record is Dr. Kevin Blankenship Md (Ceo)

NPI
1205344355
Provider Name
JACOB'S LADDER AT BROOKSIDE FARM, LLC
Entity Type
Organization
Location Address
25208 GEORGE WASHINGTON HWY AURORA, WV 26705
Location Phone
(304) 239-1214
Mailing Address
515 GRAND ST MORGANTOWN, WV 26501
Mailing Phone
(304) 290-0000
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-10-2018
Last Update Date
01-10-2018
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rehabilitation, Substance Use Disorder

Taxonomy Code
261QR0405X
Type
Ambulatory Health Care Facilities
License State
WV

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. KEVIN BLANKENSHIP MD

Authorized Official Title
CEO
Authorized Official Phone
(304) 290-0000

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
51D2145661
Facility Type
Other - INPATIENT ADDICTION TREAT
Certificate Effective Date
March 13, 2026
Certificate Expiration Date
March 12, 2028
Laboratory Director
DR. KEVIN J. BLANKENSHIP
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Jacob's Ladder At Brookside Farm, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1205344355, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
0
Doubled → 0
Pos 4
5
Unchanged
Pos 5
3
Doubled → 6
Pos 6
4
Unchanged
Pos 7
4
Doubled → 8
Pos 8
3
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 3 → 6 4 → 8 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 0 + 5 + 6 + 4 + 8 + 3 + 1 + 0 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1205344355.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Peer Specialist
25208 GEORGE WASHINGTON HWY
AURORA, WV 26705
Peer Specialist
25208 GEORGE WASHINGTON HWY
AURORA, WV 26705
Peer Specialist
25208 GEORGE WASHINGTON HWY
AURORA, WV 26705

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205344355, enumerated as an "organization" on January 10, 2018.

The provider is located at 25208 GEORGE WASHINGTON HWY AURORA, WV 26705 and the phone number is (304) 239-1214.

Clinic/Center with taxonomy code 261QR0405X and a focus in Rehabilitation, Substance Use Disorder.