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General NPI Number Information
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NPI Number | 1255403226
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Entity Type | Organization
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Legal Business Name | BJ ASSOCIATES
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 3006 CAPE HENRY AVE
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City | NORFOLK
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State | VA
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Zip | 23509-2219
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Country | US
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Telephone | 757-282-6904
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Fax | 757-282-6905
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Provider Business Mailing Address
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Address Line | 3006 CAPE HENRY AVE
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City | NORFOLK
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State | VA
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Zip | 23509-2219
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Country | US
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Telephone | 757-282-6904
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Fax | 757-282-6905
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | MR. BAFFOUR EDUSEI OPOKU
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Credential | M.A.T
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Telephone | 757-282-6904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | SS-293-06
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License Number State | VA
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