Provider Demographics
NPI:1285844084
Name:BAKER HALL INC
Entity Type:Organization
Organization Name:BAKER HALL INC
Other - Org Name:OLV HUMAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/COO
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARZYCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-828-9751
Mailing Address - Street 1:790 RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:LACKAWANNA
Mailing Address - State:NY
Mailing Address - Zip Code:14218-1629
Mailing Address - Country:US
Mailing Address - Phone:716-828-9751
Mailing Address - Fax:716-828-9450
Practice Address - Street 1:790 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LACKAWANNA
Practice Address - State:NY
Practice Address - Zip Code:14218-1629
Practice Address - Country:US
Practice Address - Phone:716-828-9699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY76000440320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00860417Medicaid