Healthcare Provider Details

I. General information

NPI: 1225408396
Provider Name (Legal Business Name): BJCC HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 10/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6209 ERLAND WAY
LANHAM MD
20706-2481
US

IV. Provider business mailing address

6209 ERLAND WAY
LANHAM MD
20706-2481
US

V. Phone/Fax

Practice location:
  • Phone: 240-476-0430
  • Fax:
Mailing address:
  • Phone: 240-476-0430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CIDONNE KEJANG
Title or Position: ADMINISTRATOR
Credential:
Phone: 240-476-0430