Provider Demographics
NPI:1235288861
Name:FAMILY BEHAVIORAL HEALTH CARE, LLC
Entity type:Organization
Organization Name:FAMILY BEHAVIORAL HEALTH CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ELWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:440-460-0140
Mailing Address - Street 1:6700 BETA DR STE 108
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2335
Mailing Address - Country:US
Mailing Address - Phone:440-460-0140
Mailing Address - Fax:440-460-5413
Practice Address - Street 1:6700 BETA DR STE 108
Practice Address - Street 2:
Practice Address - City:MAYFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44143-2335
Practice Address - Country:US
Practice Address - Phone:440-460-0140
Practice Address - Fax:440-460-5413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH709142000OtherMAGELLAN
OHFA9339901Medicare ID - Type Unspecified