| 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 (Licence: PA 807230) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2022-03-10 |