Provider Demographics
NPI:1104279777
Name:BAYADA
Entity type:Organization
Organization Name:BAYADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-979-5266
Mailing Address - Street 1:11709 WEST DALEY LANE
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85373
Mailing Address - Country:US
Mailing Address - Phone:623-777-1921
Mailing Address - Fax:
Practice Address - Street 1:18001 N. 79TH AVE
Practice Address - Street 2:BLDG A, SUITE 3
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:623-979-5266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11770251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health