Gaudenzia Re-Entry House
LBN: Gaudenzia Inc
Gaudenzia Re-Entry House is an health care organization with primary practice located at 2100 W Venango St , Philadelphia PA 19140-3937. The organization recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder is the primary health care specialty.
Gaudenzia Inc can be contacted via phone (215) 438-5082, or through Williams, Mike via phone (484) 338-3731.
Contact Information
Primary practice address
2100 W Venango St
Philadelphia PA 19140-3937
Phone: (215) 438-5082
Fax: (215) 438-4159
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Community/Behavioral Health | 251S00000X | 807308 | Pennsylvania |
| Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder | 261QR0405X | 807308 | Pennsylvania |
Profile Details
| NPI number | 1083743975 |
|---|---|
| LBN Legal business name | Gaudenzia Inc |
| DBA Doing business as | Gaudenzia Re-Entry House |
| Authorized official | Williams, Mike |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 5th, 2007 |
| Last updated | Jun 21st, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083743975 | NPPES |
| Pennsylvania | MEDICAID | 1002285890051 | |
| Pennsylvania | MEDICAID | 1002285890052 |
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