Provider Demographics
NPI:1528204302
Name:BJ ASSOCIATES
Entity Type:Organization
Organization Name:BJ ASSOCIATES
Other - Org Name:QUEENS HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BAFFOUR
Authorized Official - Middle Name:EDUSEI
Authorized Official - Last Name:OPOKU
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:757-469-0517
Mailing Address - Street 1:2801 HYDE LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-8228
Mailing Address - Country:US
Mailing Address - Phone:757-469-0517
Mailing Address - Fax:757-368-5343
Practice Address - Street 1:2801 HYDE LN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-8228
Practice Address - Country:US
Practice Address - Phone:757-469-0517
Practice Address - Fax:757-368-5343
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BJ ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-27
Last Update Date:2008-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA896-14-002320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness