OrganizationActive
Gaudenzia
NPI 1922273564 · Substance Use Disorder Rehabilitation Clinic/Center · Philadelphia, PA
Provider details
- NPI number
- 1922273564
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mike Williams, Sr. Contracting Manager(484) 338-3731
- License
- 807404 (PA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1834 W Tioga St
Philadelphia, PA 19140-4939
Phone: (215) 228-7595
Fax: (215) 965-7779
Approximate (ZIP-level) locationGet directions
Mailing address
106 W Main St
Norristown, PA 19401-4716
Other names (DBA / former)
- Other name
- Gaudenzia Winner Program
- Other name
- Gaudenzia Winner Program
Registry dates
- Enumerated
- 2008-04-24
- Last updated
- 2022-03-10
- Certified
- 2022-03-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.