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General NPI Number Information
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NPI Number | 1225360951
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Entity Type | Organization
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Legal Business Name | GAUDENZIA INC.
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Dates
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Enumeration Date | 02/05/2010
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 907 GIBSON BLVD
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City | HARRISBURG
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State | PA
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Zip | 17113-1860
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Country | US
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Telephone | 717-564-0427
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Fax | 717-564-0501
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Provider Business Mailing Address
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Address Line | 106 W MAIN ST
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City | NORRISTOWN
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State | PA
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Zip | 19401-4716
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Country | US
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Telephone | 610-239-9600
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Fax | 610-275-7025
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Authorized Official
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Title or Position | CONTRACT MANAGER
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Name | MIKE WILLIAMS
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Credential |
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Telephone | 484-338-3731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 327810
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License Number State | PA
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