NPIMap

Organization Active NPI

Gaudenzia Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ashland, PA
National Provider Identifier
1487779294
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
547013 Issued in PA
Legal business name
GAUDENZIA INC
Practice address
95 Broad St
Ashland, PA 17921-2101
Phone
(570) 875-4700
Fax
(570) 875-4260
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Michael J Moyle, J.D.
Title
Dir. Fiscal & Corporate Operations
Phone
(610) 239-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 547013 PA Primary

Addresses

Primary practice location

95 Broad St
Ashland, PA 17921-2101

Mailing address

106 W Main St
Norristown, PA 19401-4716
Phone (610) 239-9600

Other identifiers 2

IdentifierTypeStateIssuer
1002285890035MedicaidPA
1002285890036MedicaidPA

Other names 1

  • GAUDENZIA FOUNTAIN SPRINGS Other name

National Provider Directory

National Provider Directory
Tax ID family
Gaudenzia77 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Locations

95 Broad St
Ashland, PA 17921
Phone (570) 875-4700

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487779294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W MAIN ST",
            "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": "95 BROAD ST",
            "city": "ASHLAND",
            "state": "PA",
            "postal_code": "179212101",
            "telephone_number": "570-875-4700",
            "fax_number": "570-875-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUDENZIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOYLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIR. FISCAL & CORPORATE OPERATIONS",
        "authorized_official_telephone_number": "610-239-9600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PA",
            "license": "547013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002285890035",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002285890036",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GAUDENZIA FOUNTAIN SPRINGS",
            "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 22, 2020; 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.