Organization
GAUDENZIA INC
Active
Other names
GAUDENZIA ELSIE SHENK OUTPATIENT
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J MOYLE J.D. (DIR. FISCAL & CORPORATE OPERATIONS)
(610) 239-9600
Entity
Organization
Contact information
Practice address
211 EAST MIFFLIN STREET, LANCASTER, PA 17602
(717) 286-9088
(717) 286-9091
Mailing address
106 WEST MAIN STREET, NORRISTOWN, PA 19401-4716
(610) 239-9600
(610) 275-7025
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
367081
PA
261Q00000X
Clinic/Center
Primary
367081
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002285890060
—
PA
Enumeration date
04/20/2007
Last updated
01/14/2008
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