NPIMap

Organization Active NPI

Gaudenzia Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ashland, PA
National Provider Identifier
1093933749
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
547023 Issued in PA
Legal business name
GAUDENZIA INC
Practice address
91 Broad Street
Ashland, PA 17921
Phone
(570) 875-2287
Fax
(570) 875-2203
NPI assigned
Apr 20, 2007
Last updated
Aug 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mike Williams
Title
Sr. Contract Manager
Phone
(484) 338-3731

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 547023 PA Primary

Addresses

Primary practice location

91 Broad Street
Ashland, PA 17921

Mailing address

106 West Main Street
Norristown, PA 19401-4716
Phone (610) 239-9600

Other names 1

  • GAUDENZIA NEW DESTINY Other name

National Provider Directory

National Provider Directory
Tax ID family
Gaudenziaorg77 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

91 Broad St
Ashland, PA 17921
Phone (570) 875-2287

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1093933749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 WEST MAIN STREET",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194014716",
            "telephone_number": "610-239-9600",
            "fax_number": "610-275-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 BROAD STREET",
            "city": "ASHLAND",
            "state": "PA",
            "postal_code": "17921",
            "telephone_number": "570-875-2287",
            "fax_number": "570-875-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUDENZIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "SR. CONTRACT MANAGER",
        "authorized_official_telephone_number": "484-338-3731"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PA",
            "license": "547023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GAUDENZIA NEW DESTINY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "GAUDENZIA NEW DESTINY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ashland, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.