# BELLEFAIRE JCB

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WINGSPAN CARE GROUP
- **Other names:** Monarch Boarding Academy - South
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1457747537
- **Legal business name:** WINGSPAN CARE GROUP
- **Authorized official:** MR. THOMAS J BROWNE (CFO)
- **Authorized official phone:** (216) 320-8221

## Contact information

- **Practice address:** 22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4819
- **Practice address phone:** (216) 932-2800
- **Practice address fax:** (216) 932-6704
- **Mailing address:** 22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4819
- **Mailing address phone:** (216) 932-2800
- **Mailing address fax:** (216) 932-6704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251X00000X | Supports Brokerage Agency | 06-7516 | OH | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | 06-7516 | OH | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 06-7516 | OH | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 06-7516 | OH | Yes |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | 06-7516 | OH | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 06-7516 | OH | — |
| 323P00000X | Psychiatric Residential Treatment Facility | 06-7516 | OH | — |
| 385HR2055X | Child Mental Illness Respite Care | 06-7516 | OH | — |
| 385HR2065X | Child Physical Disabilities Respite Care | 06-7516 | OH | — |

## Other

- **Enumeration date:** 04/15/2015
- **Last updated:** 04/15/2015