Organization
BELLEFAIRE JCB
Active
Parent organization
WINGSPAN CARE GROUP
Other names
Monarch Psychiatric Residential Treatment Facility
Organization subpart
Yes
Provider details
NPI number
Legal business name
WINGSPAN CARE GROUP
Authorized official
MRS. LEIGH HALL (GENERAL COUNSEL)
(216) 320-8222
Entity
Organization
Contact information
Practice address
22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4819
(216) 932-2800
(216) 932-6704
Mailing address
22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4819
(216) 932-2800
(216) 932-6704
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
12-1949
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06-8251
ODMHAS LICENSE
OH
05
—
TBD
—
OH
Enumeration date
11/06/2014
Last updated
09/17/2024
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