Gaudenzia Winner Program

LBN: Gaudenzia
Gaudenzia Winner Program is an health care organization with primary practice located at 1834 W Tioga St , Philadelphia PA 19140-4939. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder, which is considered as the primary health care specialty. Gaudenzia can be contacted via phone (215) 228-7595, or through Williams, Mike via phone (484) 338-3731.

Contact Information

Primary practice address
1834 W Tioga St Philadelphia PA 19140-4939
Phone: (215) 228-7595
Fax: (215) 965-7779
Website:
Map and Directions
Authorized official contact:
Name: Williams, Mike
Phone: (484) 338-3731

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 807404 Pennsylvania

Profile Details

NPI number 1922273564
LBN Legal business name Gaudenzia
DBA Doing business as Gaudenzia Winner Program
Authorized official Williams, Mike
Entity Organization
Organization subpart 1 No
Enumeration date Apr 24th, 2008
Last updated Mar 10th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922273564 NPPES
Pennsylvania MEDICAID 1002285890071

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