Provider Demographics
NPI:1790588572
Name:BAIG LLC
Entity type:Organization
Organization Name:BAIG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUGUETTE
Authorized Official - Middle Name:BAI CHANTAL
Authorized Official - Last Name:GANLONON COOVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-502-1035
Mailing Address - Street 1:3317 N 107TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3664
Mailing Address - Country:US
Mailing Address - Phone:402-502-1035
Mailing Address - Fax:402-502-1478
Practice Address - Street 1:3317 N 107TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-3664
Practice Address - Country:US
Practice Address - Phone:402-502-1035
Practice Address - Fax:402-502-1478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities