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General NPI Number Information
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NPI Number | 1518882836
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Entity Type | Organization
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Legal Business Name | MG DDD, LLC
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 1801 WASHINGTON VALLEY RD
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City | MARTINSVILLE
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State | NJ
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Zip | 08836-2004
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Country | US
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Telephone | 732-221-5455
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Fax |
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Provider Business Mailing Address
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Address Line | 19 BELLAVISTA CT
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City | EDISON
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State | NJ
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Zip | 08820-4438
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Country | US
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Telephone | 732-221-5455
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. JESSICA DIANE LITTLE
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Credential |
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Telephone | 484-666-8507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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