MEDICARE: BJK ENTERPRISES, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	007850	TX

General Provider Information

NPI Number	:	1114916020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BJK ENTERPRISES, INC

Provider Business Mailing Address
First Line	:	306 E RANDOL MILL RD
Second Line	:	SUITE 160
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5819
Country	:	US
Telephone Number	:	817-461-0154
Fax Number	:	817-275-9792

Provider Business Practice Location Address
First Line	:	306 E RANDOL MILL RD
Second Line	:	SUITE 160
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5819
Country	:	US
Telephone Number	:	817-461-0154
Fax Number	:	817-275-9792

Authorized Official
Title or Position	:	CEO/ADMINISTRATOR
Name	:	MRS. BALINDA JEAN ANTOINE
Credential	:
Telephone Number	:	817-461-0154

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	03/31/2008

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