NPI | 1730212861 |
---|---|
Other Name | GAUDENZIA NEW IMAGE |
Entity Type | Organization |
Authorized Contact | MIKE WILLIAMS Sr. Contracting Manager 484-338-3731 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: PA 807230) |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: PA 807230) |
Enumeration Date | 2007-03-14 |
Last Update Date | 2022-03-10 |