NPIMap

Organization Active NPI

Gaudenzia Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1629295076
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
807204 Issued in PA
Legal business name
GAUDENZIA INC
Practice address
701 North 63Rd Street
Philadelphia, PA 19151
Phone
(215) 477-0063
Fax
(215) 477-3318
NPI assigned
Apr 19, 2007
Last updated
Jun 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Authorized official

Name
Mr. Michael Coyle, CPA
Title
Dir. Fiscal & Accounting Operations
Phone
(610) 239-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 807204 PA Primary

Addresses

Primary practice location

701 North 63Rd Street
Philadelphia, PA 19151

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1002285890088MedicaidPA

Other names 1

  • GAUDENZIA FOCUS HOUSE 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

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1629295076",
    "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": "701 NORTH 63RD STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19151",
            "telephone_number": "215-477-0063",
            "fax_number": "215-477-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUDENZIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "COYLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIR. FISCAL & ACCOUNTING OPERATIONS",
        "authorized_official_telephone_number": "610-239-9600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PA",
            "license": "807204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002285890088",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GAUDENZIA FOCUS HOUSE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.