Provider Demographics
NPI:1508439597
Name:BOJ HEALTH CORP
Entity Type:Organization
Organization Name:BOJ HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:YAW
Authorized Official - Middle Name:BEDIAKO
Authorized Official - Last Name:POKU
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:480-250-7412
Mailing Address - Street 1:3924 E ANDRE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-9161
Mailing Address - Country:US
Mailing Address - Phone:480-250-7412
Mailing Address - Fax:
Practice Address - Street 1:3924 E ANDRE AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-9161
Practice Address - Country:US
Practice Address - Phone:480-250-7412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities