Provider Demographics
NPI:1952097131
Name:BJT BEHAVIORAL HEALTH CENTER
Entity Type:Organization
Organization Name:BJT BEHAVIORAL HEALTH CENTER
Other - Org Name:BJT BEHAVIORAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OSAYANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFRED-IYAMU
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:469-450-7164
Mailing Address - Street 1:8600 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5632
Mailing Address - Country:US
Mailing Address - Phone:469-450-7164
Mailing Address - Fax:
Practice Address - Street 1:450 CENTURY PKWY STE 250
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8136
Practice Address - Country:US
Practice Address - Phone:469-740-3341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1110235OtherAPRN