Organization
GAUDENZIA INC
Active
Other names
GAUDENZIA FOCUS 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
701 NORTH 63RD STREET, PHILADELPHIA, PA 19151
(215) 477-0063
(215) 477-3318
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
807204
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002285890088
—
PA
Enumeration date
04/19/2007
Last updated
06/22/2016
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