Organization
MUDARIS HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE DERRICOTTE (DIRECTOR)
(646) 420-3010
Entity
Organization
Contact information
Practice address
4590 VALLEY PKWY SE APT E, SMYRNA, GA 30082-4981
(646) 420-3010
Mailing address
1300 RIDENOUR BLVD NW STE 100, KENNESAW, GA 30152-4528
(470) 995-1258
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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