Provider Demographics
NPI:1255372249
Name:BAYADA HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:BAYADA HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-909-5159
Mailing Address - Street 1:99 CHERRY HILL RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1122
Mailing Address - Country:US
Mailing Address - Phone:973-909-5159
Mailing Address - Fax:973-909-5112
Practice Address - Street 1:12048 TESSON FERRY RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-1727
Practice Address - Country:US
Practice Address - Phone:314-849-1188
Practice Address - Fax:314-849-5187
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYADA HOME HEALTH CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-09
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251E00000X
MO745-1164W00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO286056304Medicaid
MO266056308Medicaid
MO586068702Medicaid