Provider Demographics
NPI:1225408396
Name:BJCC HEALTH SERVICES
Entity Type:Organization
Organization Name:BJCC HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CIDONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEJANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-476-0430
Mailing Address - Street 1:6209 ERLAND WAY
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2481
Mailing Address - Country:US
Mailing Address - Phone:240-476-0430
Mailing Address - Fax:
Practice Address - Street 1:6209 ERLAND WAY
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2481
Practice Address - Country:US
Practice Address - Phone:240-476-0430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management