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General NPI Number Information
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NPI Number | 1447384367
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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 | 03/15/2007
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 1306 SPRING GARDEN ST 2ND AND 3RD FLOORS
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City | PHILADELPHIA
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State | PA
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Zip | 19123-3213
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Country | US
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Telephone | 215-413-8268
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Fax | 215-413-8276
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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 | DIR. FISCAL & CORPORATE OPERATIONS
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Name | MR. MICHAEL J MOYLE
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Credential | J.D.
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Telephone | 610-239-9600
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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 | 850179
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 850179
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License Number State | PA
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