Healthcare Provider Details

I. General information

NPI: 1003740317
Provider Name (Legal Business Name): BKJ WORKFIRST MOVEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 ST MARY'S AVE 103
LA PLATA MD
20646
US

IV. Provider business mailing address

109 ST MARY'S AVE 103
LA PLATA MD
20646
US

V. Phone/Fax

Practice location:
  • Phone: 240-320-2024
  • Fax:
Mailing address:
  • Phone: 240-320-2042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: BEATRICE KRISTIN JOHNSON
Title or Position: CEO
Credential: BD
Phone: 240-320-2042