Healthcare Provider Details

I. General information

NPI: 1275358061
Provider Name (Legal Business Name): ATTAIN BH BEACHWOOD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23611 CHAGRIN BLVD
BEACHWOOD OH
44122-5540
US

IV. Provider business mailing address

71 HALLEY DR
POMONA NY
10970-2108
US

V. Phone/Fax

Practice location:
  • Phone: 888-442-2323
  • Fax:
Mailing address:
  • Phone: 718-213-3530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAIM NEIMAN
Title or Position: OWNER
Credential:
Phone: 845-445-5371