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BELLEFAIRE JCB NPI 1629337704


NPI Information

NPI: 1629337704
Provider Name: BELLEFAIRE JCB
Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
Entity Type: Organization

Specialization: Substance Abuse Treatment, Children

Address:
22001 FAIRMOUNT BLVD
SHAKER HEIGHTS, OH
ZIP 44118
Phone: (216) 932-2800
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BELLEFAIRE JCB is a substance abuse treatment and children substance abuse rehabilitation facility in Shaker Heights, OH. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. BELLEFAIRE JCB NPI is 1629337704. The provider is registered as an organization entity type.

The provider's business location address is:

22001 FAIRMOUNT BLVD
SHAKER HEIGHTS, OH
ZIP 44118-819
Phone: (216) 932-2800
Fax: (216) 932-6704

The provider's authorized official is Thomas J Browne .
The authorized official title is Cfo and has the following contact phone number (216) 320-8221.

The enumeration date for this NPI number is 5/10/2012 and was last updated on 5/17/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0405XClinic/CenterRehabilitation, Substance Use Disorder02447OHIONo
2324500000XSubstance Abuse Rehabilitation Facility02447OHIONo
33245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children02447OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
110415MEDICAIDOHIO
202447MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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