=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134467855
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAYADA HOME HEALTH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2013
-----------------------------------------------------
Last Update Date | 07/01/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20205 CORTEZ BLVD UNIT A-CENTER
-----------------------------------------------------
City | BROOKSVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34601-3847
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-796-2200
-----------------------------------------------------
Fax | 352-796-2500
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 99 CHERRY HILL RD SUITE 302
-----------------------------------------------------
City | PARSIPPANY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07054-1122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-909-5159
-----------------------------------------------------
Fax | 973-909-5112
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | DAVID BAIADA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 856-662-4300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 299994141
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------