NPIMap

Organization Active NPI

Bellefaire JCB

  • Psychiatric Residential Treatment Facility
  • Shaker Heights, OH
National Provider Identifier
1497151104
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
12-1949 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
Nov 6, 2014
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WINGSPAN CARE GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Mrs. Leigh Hall
Title
General Counsel
Phone
(216) 320-8222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 12-1949 OH Primary

Addresses

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 2

IdentifierTypeStateIssuer
06-8251OtherOHODMHAS LICENSE
TBDMedicaidOH

Other names 1

  • Monarch Psychiatric Residential Treatment Facility Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497151104. Details of each certification follow.

  • CCN 36L003 Psychiatric residential treatment facility · Active · Name & address match · Details

Psychiatric residential treatment facility certification: CCN 36L003

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BELLEFAIRE JEWISH CHILDREN'S BUREAU
Certification status
Active
Provider type (POS)
Psychiatric residential treatment facility
Participating since
Oct 10, 2024
Last certification
Oct 10, 2024
Beds
6
Ownership / control type
For profit – individual
Facility address
22001 Fairmount Blvd
Shaker Heights, OH 44118

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.

NPI Registry JSON

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1497151104",
    "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": "2014-11-06",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "LEIGH",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "216-320-8222",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "OH",
            "license": "12-1949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODMHAS LICENSE",
            "identifier": "06-8251",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TBD",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monarch Psychiatric Residential Treatment Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shaker Heights, OH

Sources for this page

Verify at the official NPI Registry.