Provider Demographics
NPI:1811404189
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 1:2630 PRESERVE DR
Mailing Address - Street 2:
Mailing Address - City:FINKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21048-2251
Mailing Address - Country:US
Mailing Address - Phone:410-299-2039
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?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)