Organization
GAUDENZIA
Active
Other names
GAUDENZIA CHAMBERS HILL ADOLESCENT PROGRAM
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
3740 CHAMBERS HILL RD, HARRISBURG, PA 17111-1510
(717) 561-0400
(717) 561-0896
Mailing address
106 W MAIN ST, 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
227057
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002285890043
—
PA
05
—
1002285890044
—
PA
Enumeration date
03/19/2007
Last updated
08/22/2020
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