Basic Information
Provider Information
NPI: 1134508716
EntityType: 2
ReplacementNPI:  
OrganizationName: BAYADA HOME CARE
LastName:  
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Credential:  
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Mailing Information
Address1: 4300 HADDONFIELD RD
Address2:  
City: PENNSAUKEN
State: NJ
PostalCode: 081093376
CountryCode: US
TelephoneNumber: 9739095159
FaxNumber:  
Practice Location
Address1: 427 ALA MAKANI STREET
Address2: SUITE 200
City: KAHULUI
State: HI
PostalCode: 96732
CountryCode: US
TelephoneNumber: 8082446879
FaxNumber: 8088730273
Other Information
ProviderEnumerationDate: 05/28/2015
LastUpdateDate: 04/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BAIADA
AuthorizedOfficialFirstName: DAVID
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT/CEO
AuthorizedOfficialTelephone: 8566624300
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: BAYADA HOME HEALTH CARE, INC.
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AuthorizedOfficialCredential:  
NPICertificationDate: 04/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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