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Organization

BEECH BROOK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS ROYER MPA (CHIEF EXECUTIVE OFFICER)
(216) 831-2255
Entity
Organization

Contact information

Practice address
13201 GRANGER RD STE 8, GARFIELD HEIGHTS, OH 44125-1979
(216) 831-2255
(216) 831-0436
Mailing address
13201 GRANGER RD STE 8, GARFIELD HEIGHTS, OH 44125-1979
(216) 831-2255
(216) 831-0436

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
12773
OH
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
208
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2871101
OH
Enumeration date
09/26/2006
Last updated
07/09/2024
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