Baho Residential Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

BAHO RESIDENTIAL CARE LLC

Practice address

715 10TH St NE Apt 201
Jamestown, ND 58401-3456

Phone

(704) 890-1186

NPI assigned

Mar 13, 2024

Last updated

Mar 13, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fred Rwigema, MD

Title

Managing Director

Phone

(704) 890-1186

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1871352872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 10TH ST NE APT 201",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013456",
            "telephone_number": "704-890-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 10TH ST NE APT 201",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013456",
            "telephone_number": "704-890-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAHO RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "RWIGEMA",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "704-890-1186",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.