Provider Demographics
NPI:1053790634
Name:BAYADA HOME CARE
Entity type:Organization
Organization Name:BAYADA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-662-4300
Mailing Address - Street 1:4300 HADDONFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-3376
Mailing Address - Country:US
Mailing Address - Phone:973-909-5159
Mailing Address - Fax:
Practice Address - Street 1:1221 KILAUEA AVENUE
Practice Address - Street 2:SUITE 60
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-969-9622
Practice Address - Fax:808-963-9894
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYADA HOME HEALTH CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-28
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI793936-01Medicaid