Organization · Type 2 NPI
Gaudenzia DRC Inc
Substance Use Disorder Rehabilitation Clinic/Center · Philadelphia, PA
NPI number
1073736104
Active
Practice location
3200 Henry Ave
Philadelphia, PA 19129-1137
Fax (215) 991-9796
Mailing address
106 W Main St
Norristown, PA 19401-4716
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center | 261Q00000X | 800103 (PA) |
| Substance Use Disorder Rehabilitation Clinic/Center Primary | 261QR0405X | 800103 (PA) |
Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...
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About NPI 1073736104
Gaudenzia DRC Inc's National Provider Identifier is 1073736104, issued on Apr 10, 2007. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Philadelphia, PA. The record was last updated on Jul 19, 2010.