Organization
VIDA HEALTHCARE LLC
Active
Other names
Vida Healthcare LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISAAC O FADEYIBI (CEO)
(443) 627-3104
Entity
Organization
Contact information
Practice address
18348 SPARK OR, UNIT 201, HAGERSTOWN, MD 21740-2086
(443) 627-3104
Mailing address
3410 KELOX RD, GWYNN OAK, MD 21207-6203
(443) 627-3104
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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