Organization
VIDMA CARE MISSION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID E UGHULU (EXECUTIVE DIRECTOR)
(404) 551-0549
Entity
Organization
Contact information
Practice address
15 CANNON ST, WEST ORANGE, NJ 07052-3646
(404) 551-0549
Mailing address
15 CANNON ST, WEST ORANGE, NJ 07052-3646
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
02/10/2025
Last updated
02/10/2025
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