Gaudenzia At Park Heights

LBN: Gaudenzia Inc
Gaudenzia At Park Heights is an health care organization with primary practice located at 4615 Park Heights Ave , Baltimore MD 21215-6331. 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 Inc can be contacted via phone (443) 423-1500, or through Williams, Mike via phone (484) 338-3731.

Contact Information

Primary practice address
4615 Park Heights Ave Baltimore MD 21215-6331
Fax: (443) 423-1495
Website:
Authorized official contact:
Name: Williams, Mike

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X 10478 Maryland
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 12536 Maryland

Profile Details

NPI number 1366656175
LBN Legal business name Gaudenzia Inc
DBA Doing business as Gaudenzia At Park Heights
Authorized official Williams, Mike
Entity Organization
Organization subpart 1 No
Enumeration date May 10th, 2007
Last updated Jun 24th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366656175 NPPES
Maryland MEDICAID 4171233 00

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