# VIDMA CARE MISSION, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265247035
- **Authorized official:** DAVID E UGHULU (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (404) 551-0549

## Contact information

- **Practice address:** 15 CANNON ST, WEST ORANGE, NJ 07052-3646
- **Practice address phone:** (404) 551-0549
- **Mailing address:** 15 CANNON ST, WEST ORANGE, NJ 07052-3646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 02/10/2025
- **Last updated:** 02/10/2025