Provider Demographics
NPI:1982580007
Name:BAMADE CARE LLC
Entity type:Organization
Organization Name:BAMADE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DACCU
Authorized Official - Middle Name:
Authorized Official - Last Name:SONUBI-ISHAQ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:309-966-5184
Mailing Address - Street 1:99 LENOX AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-3102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:99 LENOX AVE FL 1
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-3102
Practice Address - Country:US
Practice Address - Phone:309-966-5184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities