Provider Demographics
NPI:1336242841
Name:BAYSIDE SOLUTIONS, INC.
Entity Type:Organization
Organization Name:BAYSIDE SOLUTIONS, INC.
Other - Org Name:AADI HOME HEALTH AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:
Authorized Official - Last Name:RENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-452-3384
Mailing Address - Street 1:PO BOX 61057
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-1057
Mailing Address - Country:US
Mailing Address - Phone:361-452-3384
Mailing Address - Fax:361-452-0110
Practice Address - Street 1:1001 2ND ST BLDG 1
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2374
Practice Address - Country:US
Practice Address - Phone:361-452-3384
Practice Address - Fax:361-452-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012214251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184931710Medicaid
TX67-9617Medicare PIN
TX184931710Medicaid