Organization Active NPI

Gaudenzia Inc

  • Community/Behavioral Health Agency
  • Erie, PA
National Provider Identifier
1922180652
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GAUDENZIA INC
Practice address
414 W 5TH St
Erie, PA 16507-1214
Phone
(814) 459-4775
Fax
(814) 453-6118
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Substance Abuse Rehabilitation Facility 324500000X 251086 PA
Substance Abuse Rehabilitation Facility 324500000X 257046 PA
Substance Abuse Rehabilitation Facility 324500000X 257048 PA
Substance Abuse Rehabilitation Facility 324500000X 257079 PA
Substance Abuse Rehabilitation Facility 324500000X 257080 PA
Substance Abuse Rehabilitation Facility 324500000X 257081 PA
Substance Abuse Rehabilitation Facility 324500000X 257082 PA
Substance Abuse Rehabilitation Facility 324500000X 257083 PA
Substance Abuse Rehabilitation Facility 324500000X 437029 PA

Addresses

Primary practice location

414 W 5TH St
Erie, PA 16507-1214

Mailing address

106 W Main St Ste 202
Norristown, PA 19401-4716
Phone (610) 239-9600

Other identifiers 7

IdentifierTypeStateIssuer
0815OtherPABLUE CROSS BLUE SHEILD
459802OtherPAVALUE OPTIONS
VO543BOtherPAUPMC
0018923880001MedicaidPA
1018307530003MedicaidPA
60054OtherPAAETNA
0018923880001OtherPACCBHO

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 17

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

View all 17

Locations

414 W 5th St
Erie, PA 16507
Phone (814) 459-4775

2005 W 8th St
Ste 202
Erie, PA 16505
Phone (478) 246-7577

106 W Main St
Ste 202
Norristown, PA 19401

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1922180652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W MAIN ST STE 202",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194014716",
            "telephone_number": "610-239-9600",
            "fax_number": "814-616-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W 5TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071214",
            "telephone_number": "814-459-4775",
            "fax_number": "814-453-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUDENZIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "SR. CONTRACTING MANAGER",
        "authorized_official_telephone_number": "484-338-3731"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "251086",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "257046",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "257048",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "257079",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "257080",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "257081",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "257082",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "257083",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "437029",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "0815",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "459802",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "VO543B",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018923880001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018307530003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "60054",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCBHO",
            "identifier": "0018923880001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.