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GAUDENZIA NPI 1639293418


NPI Information

NPI: 1639293418
Provider Name: GAUDENZIA

Other Name: GAUDENZIA CHAMBERS HILL ADOLESCENT PROGRAM

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
3740 CHAMBERS HILL RD
HARRISBURG, PA
ZIP 17111
Phone: (717) 561-0400
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GAUDENZIA is a rehabilitation and substance use disorder clinic center in Harrisburg, PA. GAUDENZIA NPI is 1639293418. The provider is registered as an organization entity type.
The provider Other Name Is Gaudenzia Chambers Hill Adolescent Program.

The provider's business location address is:

3740 CHAMBERS HILL RD
HARRISBURG, PA
ZIP 17111-510
Phone: (717) 561-0400
Fax: (717) 561-0896

The provider's authorized official is Michael J Moyle .
The authorized official title is Dir. Fiscal & Corporate Operations and has the following contact phone number (610) 239-9600.

The enumeration date for this NPI number is 3/19/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0405XClinic/CenterRehabilitation, Substance Use Disorder227057PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11002285890043MEDICAIDPENNSYLVANIA
21002285890044MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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