=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538816871
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEFFHOME PA, LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2022
-----------------------------------------------------
Last Update Date | 08/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 DRESHER RD STE 250
-----------------------------------------------------
City | HORSHAM
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19044-2227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-441-6701
-----------------------------------------------------
Fax | 215-441-6807
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4300 HADDONFIELD RD
-----------------------------------------------------
City | PENNSAUKEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08109-3376
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-909-5159
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DAVID BAIADA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 973-909-5159
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 315D00000X
-----------------------------------------------------
Taxonomy Name | Inpatient Hospice
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------