Organization
GAUDENZIA.ORG
Active
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
(410) 367-4447
(410) 367-4447
Mailing address
4615 PARK HEIGHTS AVE, BALTIMORE, MD 21215-6331
(410) 367-4447
(410) 367-4447
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
904854
MD
Other
Enumeration date
04/04/2013
Last updated
06/24/2021
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