Provider Demographics
NPI:1083057723
Name:PARTNERS FOR BEHAVIORAL HEALTH AND WELLNESS INC
Entity Type:Organization
Organization Name:PARTNERS FOR BEHAVIORAL HEALTH AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:BONEM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:216-916-9276
Mailing Address - Street 1:24800 HIGHPOINT RD
Mailing Address - Street 2:STE A
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-6042
Mailing Address - Country:US
Mailing Address - Phone:216-342-5496
Mailing Address - Fax:216-763-9700
Practice Address - Street 1:24800 HIGHPOINT RD
Practice Address - Street 2:STE A
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-6042
Practice Address - Country:US
Practice Address - Phone:216-342-5496
Practice Address - Fax:216-763-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-11
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3359103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH225120Medicare PIN