Basic Information
| Provider Information | |||||||||
| NPI: | 1851642359 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BAYADA HOME HEALTH CARE, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| OtherOrganizationName: | BAYADA HABILITATION | ||||||||
| 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: | 3205 RANDALL PKWY STE 212 | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284032569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103977767 | ||||||||
| FaxNumber: | 9103977765 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2012 | ||||||||
| LastUpdateDate: | 09/01/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| 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: | 09/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | N | Agencies | Home Health | 251S00000X | NC | N | Agencies | Community/Behavioral Health | 261QD1600X | NC | Y | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
No ID Information.