Provider Demographics
NPI:1407471857
Name:YANJU LLC
Entity type:Organization
Organization Name:YANJU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEALIA
Authorized Official - Middle Name:DANELLE
Authorized Official - Last Name:ADEAGBO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHT
Authorized Official - Phone:561-373-2939
Mailing Address - Street 1:7800 W OAKLAND PARK BLVD # E115
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6741
Mailing Address - Country:US
Mailing Address - Phone:954-434-4341
Mailing Address - Fax:
Practice Address - Street 1:7800 W OAKLAND PARK BLVD # E115
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6741
Practice Address - Country:US
Practice Address - Phone:954-444-4341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)