Organization
GAUDENZIA INC
Active
Other names
GAUDENZIA PROGRESS HOUSE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL COYLE CPA (DIR. FISCAL & ACCOUNTING OPERATIONS)
(610) 239-9600
Entity
Organization
Contact information
Practice address
607 EAST CHURCH LANE, APT. B-6, PHILADELPHIA, PA 19144
(215) 848-0280
(215) 848-6747
Mailing address
106 WEST MAIN STREET, 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
199110
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002285890089
—
PA
Enumeration date
04/20/2007
Last updated
06/22/2016
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