GAUDENZIA (NPI# 1922273564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922273564 |
| Entity Type | Organization |
| Organization Name | GAUDENZIA |
| Other Organization Name | GAUDENZIA WINNER PROGRAM |
| Practice Address |
1834 W Tioga St Philadelphia PA 19140-4939 |
| Mailing Address |
106 W Main St Norristown PA 19401-4716 |
| Practice Telephone | 2152287595 |
| Practice Fax Number | 2159657779 |
| Mailing Telephone | 6102399600 |
| Mailing Fax Number | 6102757025 |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |
| Authorized Official Name | MR. MICHAEL J MOYLE (DIRECTOR OF FISCAL & CORPORATE OPER) |
| Authorized Official Telephone | 6102399600 |
| Authorized Official Credential | J.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
807404 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1002285890071 | 05 |
| Other Name | Type Code |
|---|---|
| GAUDENZIA WINNER PROGRAM | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487001749 | Gaudenzia | Clinic/Center | 480 Hafer Rd, Lewisburg, PA 17837-7413 | 2016-05-17 |
| 1740652304 | Gaudenzia | Counselor | 570 Ritchie Hwy, Suite H, Severna Park, MD 21146-2925 | 2015-10-22 |
| 1639293418 | Gaudenzia | Clinic/Center | 3740 Chambers Hill Rd, Harrisburg, PA 17111-1510 | 2007-03-19 |
| 1225495609 | Gaudenzia | Clinic/Center | 201 Lincoln Way W, Mc Connellsburg, PA 17233-1319 | 2016-01-15 |
| 1215256417 | Gaudenzia | Clinic/Center | 4615 Park Heights Ave, Baltimore, MD 21215-6331 | 2010-05-27 |
| 1811011513 | Gaudenzia | Clinic/Center | 3740 Chambers Hill Rd, Harrisburg, PA 17111-1510 | 2007-03-19 |
| 1881718062 | Gaudenzia | Clinic/Center | 110 Westtown Rd, Suite 115, West Chester, PA 19382-4978 | 2007-03-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GAUDENZIA DRC, INC. | 3200 Henry Ave, Philadelphia, PA 19129-1137 |
| System for Award Management (SAM) Entities | GAUDENZIA FOUNDATION, INC. | 106 W Main St, Norristown, PA 19401-4716 |
| System for Award Management (SAM) Entities | GAUDENZIA, INC. | 106 W Main St, Norristown, PA 19401-4716 |
| Street Address |
1834 W TIOGA ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19140-4939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640519 | Desirea Grant | Registered Nurse | 2000 W. Venango Street, Phila, PA 19140 | 2020-08-19 |
| 1306316104 | Carmen Doumit | Dentist | 3223 N Broad Street, Temple University Department of Orthodontics, Philadelphia, PA 19140 | 2018-12-05 |
| 1780150375 | Samantha Marina Felix | Counselor | 3803-3805 N 5th St, Philadelphia, PA 19140 | 2018-10-22 |
| 1518485135 | Holly Marie Barbee | Dietitian, Registered | 4417 N 6th St., Philadelphia, PA 19140 | 2017-09-04 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1710416870 | Narsis Aminian | Internal Medicine | 3401 N Broad Street, Temple Hospital, Neurlogy Deartment, Philadelphia, PA 19140 | 2017-06-12 |
| 1629527338 | Alaa Khatib | Pharmacist | 4616-4650 N. Broad Street, Philadelphia, PA 19140 | 2016-09-23 |
| 1548716160 | Direct Home Health Care | In Home Supportive Care | 3550 N 9th St, Philadelphia, PA 19140 | 2016-09-01 |
| 1306399225 | Zaima Choudhry | Student in an Organized Health Care Education/Training Program | Department of Pulmonary and Sleep Medicine, 3401 North Broad Street, Zone C - 7th Floor, Philadelphia, PA 19140 | 2016-07-27 |
| 1891145504 | Saji Mathew | Pharmacist | 4530n 5th Street, Philadelphia, PA 19140 | 2016-06-14 |
| Find all providers in zip 19140 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679050900 | Limitless Recovery Center LLC | Clinic/Center | 1206 E Palmer St, Philadelphia, PA 19125-3308 | 2018-07-19 |
| 1437377181 | Gaudenzia Inc | Clinic/Center | 607 East Church Lane, Apt. B-6, Philadelphia, PA 19144 | 2007-04-20 |
| 1174741821 | Gaudenzia Inc | Clinic/Center | 1300 Spring Garden Street, Philadelphia, PA 19123 | 2007-04-20 |
| 1629295076 | Gaudenzia Inc | Clinic/Center | 701 North 63rd Street, Philadelphia, PA 19151 | 2007-04-19 |
| 1316086655 | Minsec Treatment Center | Clinic/Center | 3768 L St, Philadelphia, PA 19124-5530 | 2007-02-05 |
| 1063577989 | Resources for Human Development | Clinic/Center | 5000 Jackson St, Philadelphia, PA 19124-2117 | 2006-12-22 |
| 1477660470 | Riverside Care, Inc | Clinic/Center | 2701 N. Broad St, Philadelphia, PA 19132-2743 | 2006-08-24 |
| 1770517922 | Riverside Care, Inc | Clinic/Center | 5501 Chestnut St, Philadelphia, PA 19139-3205 | 2006-07-11 |
| 1245759943 | Merakey Recovery Services | Clinic/Center | 801 W Girard Ave, Philadelphia, PA 19122-4212 | 2017-09-13 |
| 1407226434 | Holistix Outpatient Center | Clinic/Center | 2300 S Broad St, Ste 202-203, Philadelphia, PA 19145-4461 | 2015-10-02 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19140 |
Please comment or provide details below to improve the information on GAUDENZIA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.