Gaudenzia Broad Street
LBN: Gaudenzia Inc
Gaudenzia Broad Street is an health care organization with primary practice located at 3025 N Broad St , Philadelphia PA 19132-2404. 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) 223-1167, or through Williams, Mike via phone (484) 338-3731.
Contact Information
Primary practice address
3025 N Broad St
Philadelphia PA 19132-2404
Phone: (215) 223-1167
Fax: (215) 223-1928
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Community/Behavioral Health | 251S00000X | 807255 | Pennsylvania |
| Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder | 261QR0405X | 807255 | Pennsylvania |
Profile Details
| NPI number | 1366571317 |
|---|---|
| LBN Legal business name | Gaudenzia Inc |
| DBA Doing business as | Gaudenzia Broad Street |
| Authorized official | Williams, Mike |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 5th, 2007 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366571317 | NPPES |
| Pennsylvania | MEDICAID | 1002285890053 | |
| Pennsylvania | MEDICAID | 1002285890054 |
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