Gaudenzia Drc Outpatient

LBN: Gaudenzia Drc Inc
Gaudenzia Drc Outpatient is an health care organization with primary practice located at 3200 Henry Ave , Philadelphia PA 19129-1137. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty. Gaudenzia Drc Inc can be contacted via phone (215) 991-9700, or through Moyle, Michael J via phone (610) 239-9600.

Contact Information

Primary practice address
3200 Henry Ave Philadelphia PA 19129-1137
Fax: (215) 991-9796
Website:
Authorized official contact:
Name: Moyle, Michael J J.D.

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X 807384 Pennsylvania
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 807384 Pennsylvania

Profile Details

NPI number 1043434608
LBN Legal business name Gaudenzia Drc Inc
DBA Doing business as Gaudenzia Drc Outpatient
Authorized official Moyle, Michael J J.D.
Entity Organization
Organization subpart 1 No
Enumeration date Apr 12th, 2007
Last updated Jul 19th, 2010 - about 14 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 1043434608 NPPES
Pennsylvania MEDICAID 0019613780008

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