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Organization Active NPI

Bellefaire JCB

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Shaker Heights, OH
National Provider Identifier
1457747537
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
06-7516 Issued in OH
Legal business name
BELLEFAIRE JCB
Practice address
22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Phone
(216) 932-2800
Fax
(216) 932-6704
NPI assigned
Apr 15, 2015
Organization subpart
Yes
Parent organization
WINGSPAN CARE GROUPAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Mr. Thomas J Browne
Title
Cfo
Phone
(216) 320-8221

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.

Specialties & licenses 9

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Supports Brokerage Agency 251X00000X 06-7516 OH
Developmental Disabilities Clinic/Center 261QD1600X 06-7516 OH
Adolescent and Children Mental Health Clinic/Center 261QM0855X 06-7516 OH
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 06-7516 OH Primary
Mental Illness Community Based Residential Treatment Facility 320800000X 06-7516 OH
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 06-7516 OH
Psychiatric Residential Treatment Facility 323P00000X 06-7516 OH
Child Mental Illness Respite Care 385HR2055X 06-7516 OH
Child Physical Disabilities Respite Care 385HR2065X 06-7516 OH

Addresses

NPPES NPI Registry

Primary practice location

22001 Fairmount Blvd
Shaker Heights, OH 44118-4819

Mailing address

22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Phone (216) 932-2800

Other identifiers 5

NPPES NPI Registry
IdentifierTypeStateIssuer
0525337MedicaidOH
2419958OtherOHMRDD-ODJFS
02447OtherOHUPIN
2847183MedicaidOH
2864226MedicaidOH

Other names 1

NPPES NPI Registry
  • Monarch Boarding Academy - South Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 15, 2015.

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1457747537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-932-2800",
            "fax_number": "216-932-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-932-2800",
            "fax_number": "216-932-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEFAIRE JCB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WINGSPAN CARE GROUP",
        "enumeration_date": "2015-04-15",
        "last_updated": "2015-04-15",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "OH",
            "license": "06-7516",
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "OH",
            "license": "06-7516",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "OH",
            "license": "06-7516",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OH",
            "license": "06-7516",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OH",
            "license": "06-7516",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OH",
            "license": "06-7516",
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "OH",
            "license": "06-7516",
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "OH",
            "license": "06-7516",
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": "OH",
            "license": "06-7516",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0525337",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MRDD-ODJFS",
            "identifier": "2419958",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "02447",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2847183",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2864226",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monarch Boarding Academy - South",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.