Organization
GAUDENZIA INC
Active
Other names
GAUDENZIA AT PARK HEIGHTS
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE WILLIAMS (SR. CONTRACTING MANAGER)
(484) 338-3731
Entity
Organization
Contact information
Practice address
4615 PARK HEIGHTS AVE, BALTIMORE, MD 21215-6331
(443) 423-1500
(443) 423-1495
Mailing address
106 W MAIN ST, NORRISTOWN, PA 19401-4716
(610) 239-9600
(610) 275-7025
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
10478
MD
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
12536
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4171233 00
—
MD
Enumeration date
05/10/2007
Last updated
06/24/2021
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