Basic Information
| Provider Information | |||||||||
| NPI: | 1538816871 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JEFFHOME PA, LLC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | JEFFERSON HEALTH AT HOME BY BAYADA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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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: | 225 NEWTOWN RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | WARMINSTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189745221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154416701 | ||||||||
| FaxNumber: | 2154416807 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2022 | ||||||||
| LastUpdateDate: | 05/24/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BAIADA | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8566624300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 315D00000X | N | Nursing & Custodial Care Facilities | Hospice, Inpatient | 251G00000X | Y | Agencies | Hospice Care, Community Based |
No ID Information.