Organization
GAUDENZIA INC
Active
Other names
GAUDENZIA NEW IMAGE
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE WILLIAMS (SR. CONTRACTING MANAGER)
(484) 338-3731
Entity
Organization
Contact information
Practice address
1300 E TULPEHOCKEN ST, PHILADELPHIA, PA 19138-1523
(215) 924-6322
(215) 924-5531
Mailing address
106 W MAIN ST, NORRISTOWN, PA 19401-4716
(610) 239-9600
(610) 275-7025
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
807230
PA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
807230
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002285890047
—
PA
05
—
1002285890048
—
PA
Enumeration date
03/14/2007
Last updated
03/10/2022
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