| Bellefaire Jcb | |
|
1865 N Ridge Rd E Ste D-e Lorain OH 44055-3300 | |
| (440) 324-5701 | |
| (440) 277-0459 |
| Full Name | Bellefaire Jcb |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1865 N Ridge Rd E Ste D-e, Lorain, Ohio |
| Authorized Official Name and Position | Leigh Johnson (GENERAL COUNSEL) |
| Authorized Official Contact | 2163208222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bellefaire Jcb 22001 Fairmount Blvd Shaker Heights OH 44118-4819 Ph: (216) 320-8222 | Bellefaire Jcb 1865 N Ridge Rd E Ste D-e Lorain OH 44055-3300 Ph: (440) 324-5701 |
| NPI Number | 1952369514 |
|---|---|
| Provider Enumeration Date | 05/03/2006 |
| Last Update Date | 02/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952369514 | NPI | - | NPPES |
| 02447 | Medicaid | OH | |
| 10415 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 01-0009 (Ohio) | Primary |
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