Provider Demographics
NPI:1669036687
Name:AYDAN HIGH QUALITY HEALTHCARE
Entity Type:Organization
Organization Name:AYDAN HIGH QUALITY HEALTHCARE
Other - Org Name:AYDAN NURSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPN
Authorized Official - Phone:856-449-4664
Mailing Address - Street 1:629 E WOOD ST STE 305
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-3731
Mailing Address - Country:US
Mailing Address - Phone:856-449-4664
Mailing Address - Fax:
Practice Address - Street 1:629 E WOOD ST STE 305
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360
Practice Address - Country:US
Practice Address - Phone:856-449-4664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle