Provider Demographics
NPI:1366408932
Name:ADDUS HEALTHCARE INC
Entity type:Organization
Organization Name:ADDUS HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BICKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-535-8200
Mailing Address - Street 1:6303 COWBOYS WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0329
Mailing Address - Country:US
Mailing Address - Phone:302-424-4842
Mailing Address - Fax:
Practice Address - Street 1:1675 S STATE ST STE 4C
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-5140
Practice Address - Country:US
Practice Address - Phone:302-424-4842
Practice Address - Fax:302-678-5957
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADDUS HOMECARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-24
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 251F00000X, 251J00000X
DEHHAS013251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE761414Medicaid
DE761414Medicaid
DE087033Medicare Oscar/Certification