Basic Information
Provider Information
NPI: 1740537547
EntityType: 2
ReplacementNPI:  
OrganizationName: BAYADA HOME HEALTH CARE, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4300 HADDONFIELD RD
Address2:  
City: PENNSAUKEN
State: NJ
PostalCode: 081093376
CountryCode: US
TelephoneNumber: 9739095159
FaxNumber:  
Practice Location
Address1: 1890 STATE RD. 436
Address2: SUITE 315
City: WINTER PARK
State: FL
PostalCode: 327923752
CountryCode: US
TelephoneNumber: 4076790500
FaxNumber: 4076791300
Other Information
ProviderEnumerationDate: 08/10/2012
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.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X299994062FLY AgenciesHome Health 

No ID Information.


Home