Provider Demographics
NPI:1689033375
Name:BNJ HEALTH SERVICES LLC WASHINGTON BLVD
Entity Type:Organization
Organization Name:BNJ HEALTH SERVICES LLC WASHINGTON BLVD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-624-7894
Mailing Address - Street 1:2701 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-1410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-1410
Practice Address - Country:US
Practice Address - Phone:410-624-7894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BNJ HEALTH SERVICES LLC WASHINGTON BLVD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-23
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder