Basic Information
| Provider Information | |||||||||
| NPI: | 1043211071 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAYADA HOME HEALTH CARE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 EXECUTIVE DR | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080574236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567784400 | ||||||||
| FaxNumber: | 8567784103 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 WHEATON AVE | ||||||||
| Address2: | SUITE 170 | ||||||||
| City: | MILLVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 083322003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562937909 | ||||||||
| FaxNumber: | 8562931850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2005 | ||||||||
| LastUpdateDate: | 01/17/2014 | ||||||||
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| AuthorizedOfficialLastName: | FLANNERY | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR, BILLING AND COLLECTIONS | ||||||||
| AuthorizedOfficialTelephone: | 8567784400 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BAYADA HOME HEALTH CARE, INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 22230 | NJ | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 0189651 | 05 | NJ | MEDICAID |