NPIMap

Organization Active NPI

Gaudenzia

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Harrisburg, PA
National Provider Identifier
1639293418
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
227057 Issued in PA
Legal business name
GAUDENZIA
Practice address
3740 Chambers Hill Rd
Harrisburg, PA 17111-1510
Phone
(717) 561-0400
Fax
(717) 561-0896
NPI assigned
Mar 19, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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 227057 PA Primary

Addresses

Primary practice location

3740 Chambers Hill Rd
Harrisburg, PA 17111-1510

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
1002285890044MedicaidPA
1002285890043MedicaidPA

Other names 1

  • GAUDENZIA CHAMBERS HILL ADOLESCENT PROGRAM Other name

National Provider Directory

National Provider Directory
Tax ID family
Gaudenzia Inc77 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": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639293418",
    "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": "3740 CHAMBERS HILL RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171111510",
            "telephone_number": "717-561-0400",
            "fax_number": "717-561-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUDENZIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "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": "227057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002285890044",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002285890043",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GAUDENZIA CHAMBERS HILL ADOLESCENT PROGRAM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harrisburg, 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.