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Organization

GAUDENZIA INC

Active
Other names
GAUDENZIA OUTREACH I
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL J MOYLE J.D. (DIR. OF FISCAL &CORPORATE OPERATION)
(610) 239-9600
Entity
Organization

Contact information

Practice address
1306 SPRING GARDEN ST, PHILADELPHIA, PA 19123-3213
(215) 238-2150
(215) 238-2157
Mailing address
106 W MAIN ST, NORRISTOWN, PA 19401-4716
(610) 239-9600
(610) 275-7025

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
800146
PA
261Q00000X
Clinic/Center
Primary
800146
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1002285890025
PA
05
1002285890026
PA
05
1002285890062
PA
Enumeration date
03/12/2007
Last updated
09/02/2025
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