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General NPI Number Information
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NPI Number | 1750219929
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Entity Type | Organization
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Legal Business Name | VIDA CARE LLC
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Dates
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Enumeration Date | 05/09/2026
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Last Update Date | 05/09/2026
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Provider Practice Location Address
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Address Line | 2185 LEMOINE AVE STE 1B
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City | FORT LEE
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State | NJ
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Zip | 07024-6030
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Country | US
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Telephone | 201-351-9430
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Fax |
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Provider Business Mailing Address
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Address Line | 2185 LEMOINE AVE STE 1B
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City | FORT LEE
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State | NJ
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Zip | 07024-6030
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Country | US
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Telephone | 201-351-9430
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID M BRAVERMAN
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Credential |
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Telephone | 201-351-9430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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