Healthcare Provider Details

I. General information

NPI: 1639776578
Provider Name (Legal Business Name): BAYADA HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 MAIN ST STE 650
WAILUKU HI
96793-1644
US

IV. Provider business mailing address

4300 HADDONFIELD RD
PENNSAUKEN NJ
08109-3376
US

V. Phone/Fax

Practice location:
  • Phone: 808-244-4700
  • Fax: 808-244-7575
Mailing address:
  • Phone: 973-909-5159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVID BAIADA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 856-662-4300