Basic Information
| Provider Information | |||||||||
| NPI: | 1841221751 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAYADA HOME HEALTH CARE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4300 HADDONFIELD RD | ||||||||
| Address2: | |||||||||
| City: | PENNSAUKEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081093376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9739095159 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6367 E TANQUE VERDE RD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857153829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207218800 | ||||||||
| FaxNumber: | 5207215007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 04/26/2022 | ||||||||
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| AuthorizedOfficialLastName: | BAIADA | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 8566624300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BAYADA HOME HEALTH CARE, INC. | ||||||||
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| NPICertificationDate: | 04/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | HHA-1562 | AZ | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 467672 | 05 | AZ | MEDICAID |