MEDICARE: BJ ASSOCIATES

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	320800000X	Mental Illness Community Based Residential Treatment Facility	896-14-001	VA

General Provider Information

NPI Number	:	1326240300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BJ ASSOCIATES

Provider Business Mailing Address
First Line	:	901 E INDIAN RIVER RD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23523-1723
Country	:	US
Telephone Number	:	757-469-0517
Fax Number	:	757-282-6905

Provider Business Practice Location Address
First Line	:	901 E INDIAN RIVER RD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23523-1723
Country	:	US
Telephone Number	:	757-469-0517
Fax Number	:	757-282-6905

Authorized Official
Title or Position	:	CHIEF ADMINISTRATIVE OFFICER
Name	:	MR. BAFFOUR EDUSEI OPOKU
Credential	:	M.A.
Telephone Number	:	757-469-0517

Provider Enumeration Date	:	06/02/2007
Last Update Date	:	06/18/2008

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