NPI: 1265645493
Provider Name: GAUDENZIA INC
Other Name: GAUDENZIA INC AT OWINGS MILLS
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization
Specialization: Rehabilitation, Substance Use Disorder
CLIA Number: 21D2204828
Address:
10225 JENSEN LN
OWINGS MILLS, MD
ZIP 21117
Phone: (410) 887-1503
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GAUDENZIA INC is a rehabilitation and substance use disorder clinic center in Owings Mills, MD. GAUDENZIA INC NPI is 1265645493. The provider is registered as an organization entity type.
The provider Other Name Is Gaudenzia Inc At Owings Mills.
The provider's business location address is:
10225 JENSEN LN
OWINGS MILLS, MD
ZIP 21117-700
Phone: (410) 887-1503
Fax: (410) 887-1522
The provider's authorized official is Mike Williams .
The authorized official title is Sr. Contracting Manager and has the following contact phone number (484) 338-3731.
The CLIA number assigned to this NPI record is 21D2204828 - other - residential tx with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 5/7/2007 and was last updated on 6/24/2021.