Organization
BELLEFAIRE JCB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN ROSENBLATT (MEDICAL DIRECTOR)
(216) 320-8206
Entity
Organization
Contact information
Practice address
22001 FAIRMOUNT BLVD, SHAKER HTS,., OH 44118-8919
(216) 921-8000
Mailing address
22001 FAIRMOUNT BLVD, SHAKER HTS.,, OH 44118-4819
(216) 921-8000
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
RN289240
OH
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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