Basic Information
Provider Information
NPI: 1922558733
EntityType: 2
ReplacementNPI:  
OrganizationName: BAYADA HOME HEALTH CARE, INC.
LastName:  
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Mailing Information
Address1: 101 EXECUTIVE DR
Address2: SUITE 4
City: MOORESTOWN
State: NJ
PostalCode: 080574236
CountryCode: US
TelephoneNumber: 8567784400
FaxNumber: 8567784103
Practice Location
Address1: 4100 W KENNEDY BLVD
Address2: SUITE 128
City: TAMPA
State: FL
PostalCode: 336092288
CountryCode: US
TelephoneNumber: 8132896900
FaxNumber: 8132869691
Other Information
ProviderEnumerationDate: 10/05/2016
LastUpdateDate: 10/05/2016
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: FLANNERY
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: DIRECTOR OF BILLING AND COLLECTIONS
AuthorizedOfficialTelephone: 8567784400
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: BAYADA HOME HEALTH CARE, INC.
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X  Y AgenciesHome Health 

No ID Information.


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