Organization
GAUDENZIA INC
Active
Other names
GAUDENZIA CONCEPT 90
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE WILLIAMS (SENIOR CONTRACTING MANAGER)
(484) 338-3731
Entity
Organization
Contact information
Practice address
124 EAST AZALEA DRIVE, ANDERSON HALL, HARRISBURG, PA 17110
(717) 232-3232
(717) 236-6833
Mailing address
106 W MAIN ST, NORRISTOWN, PA 19401-4716
(610) 239-9600
(610) 275-7025
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
221159
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002285890037
—
PA
05
—
1002285890038
—
PA
Enumeration date
03/20/2007
Last updated
05/05/2022
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