Bellefaire JCB
Organization Active NPI Children's Substance Abuse Rehabilitation Facility · Shaker Heights, OH
NPI 1629337704 · NPPES record last updated Jan 20, 2023
Key facts
- NPI
- 1629337704
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Children's Substance Abuse Rehabilitation Facility 3245S0500X
- License
- 02447 (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
- May 10, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- WINGSPAN CARE GROUP
Authorized official
- Name
- Leigh C Hall
- Title
- General Counsel
- Phone
- (216) 320-8222
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Bellefaire Jewish Children'S Bureau
- Part of
- Wingspan Care Group
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | 02447 | OH | |
| Substance Abuse Rehabilitation Facility | 324500000X | 02447 | OH | |
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X | 02447 | OH | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10415 | Medicaid | OH | |
| 02447 | Medicaid | OH |
Other providers in Shaker Heights, OH
- Kimberly M Bell
- Bellefaire JCB
- Bellefaire JCB
- Bellefaire JCB
- Bellefaire JCB
- Bellefaire Jewish Children'S Bureau
- Bellefaire Jewish Children'S Bureau
- Galena Belyaeva
- Hannah Bencivenni
- Kelly Bender
All providers in Shaker Heights, OH · Children's Substance Abuse Rehabilitation Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.