Organization Name: | GAUDENZIA.ORG |
NPI Number: | 1376886721 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHANDRA MCNEIL -JOHNSON (BILLING MANAGER) |
Mailing Address: | 4615 Park Heights Ave Baltimore |
State: | MD US |
Postal Code: | 212156331 |
Phone Number: | 4103674447 |
Fax Number: | 4103674447 |
NPI Enumeration Date: | 04/04/2013 |
NPI Last Update Date: | 04/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 324500000X |
License Number: | 904854 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |