The Jericho House

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

THE JERICHO HOUSE

Practice address

6757 Duncan Bridge Rd
Cleveland, GA 30528-5170

Phone

(706) 878-0015

Fax

(706) 878-0037

NPI assigned

Aug 18, 2015

Last updated

Mar 30, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Larry McKenna

Title

President

Phone

(706) 878-0015

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1528434149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 HIGHWAY 255 N",
            "city": "SAUTEE NACOOCHEE",
            "state": "GA",
            "postal_code": "305712622",
            "telephone_number": "706-878-0015",
            "fax_number": "706-878-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6757 DUNCAN BRIDGE RD",
            "city": "CLEVELAND",
            "state": "GA",
            "postal_code": "305285170",
            "telephone_number": "706-878-0015",
            "fax_number": "706-878-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JERICHO HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "MCKENNA",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-878-0015"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Cleveland, GA
• Providers in Cleveland, GA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.