NPIMap

Organization Active NPI

Bellefaire JCB

  • Children's Substance Abuse Rehabilitation Facility
  • Elyria, OH
National Provider Identifier
1376802249
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
License
0009 Issued in OH
Legal business name
BELLEFAIRE JCB
Practice address
347 Midway Blvd
Elyria, OH 44035-9006
Phone
(440) 324-5701
Fax
(440) 324-9978
NPI assigned
May 11, 2012
Last updated
May 17, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
WINGSPAN CARE GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Authorized official

Name
Thomas J Browne
Title
Cfo
Phone
(216) 320-8221

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 0009 OH
Substance Abuse Rehabilitation Facility 324500000X 0009 OH
Children's Substance Abuse Rehabilitation Facility 3245S0500X 0009 OH Primary

Addresses

Primary practice location

347 Midway Blvd
Elyria, OH 44035-9006

Mailing address

347 Midway Blvd
Elyria, OH 44035-9006
Phone (440) 324-5701

National Provider Directory

National Provider Directory
Tax ID family
Bellefaire Jewish Children's Bureau13 organizations share this tax ID, including this one
Part of
Wingspan Care Group

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

347 Midway Blvd
Elyria, OH 44035
Phone (440) 324-5555

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1376802249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 MIDWAY BLVD",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440359006",
            "telephone_number": "440-324-5701",
            "fax_number": "440-324-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 MIDWAY BLVD",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440359006",
            "telephone_number": "440-324-5701",
            "fax_number": "440-324-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEFAIRE JCB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WINGSPAN CARE GROUP",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "BROWNE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "216-320-8221"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "OH",
            "license": "0009",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OH",
            "license": "0009",
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "OH",
            "license": "0009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.