MEDICARE: MINDWELL BEHAVIOR HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	103K00000X	Behavior Analyst
3	251B00000X	Case Management Agency
4	261QM0855X	Adolescent and Children Mental Health Clinic/Center
5	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
6	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1275492142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDWELL BEHAVIOR HEALTH LLC

Provider Business Mailing Address
First Line	:	5652 STATE RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-2259
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5652 STATE RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134
Country	:	US
Telephone Number	:	779-703-4922
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ELHAN NEVZADI
Credential	:
Telephone Number	:	779-703-4922

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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