| Gaudenzia Inc | |
|
414 W 5th St Erie PA 16507-1214 | |
| (814) 459-4775 | |
| (814) 453-6118 |
| Full Name | Gaudenzia Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 414 W 5th St, Erie, Pennsylvania |
| Authorized Official Name and Position | Mike Williams (SR. CONTRACTING MANAGER) |
| Authorized Official Contact | 4843383731 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaudenzia Inc 106 W Main St Ste 202 Norristown PA 19401-4716 Ph: (610) 239-9600 | Gaudenzia Inc 414 W 5th St Erie PA 16507-1214 Ph: (814) 459-4775 |
| NPI Number | 1922180652 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 10/30/2023 |
| Certification Date | 10/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922180652 | NPI | - | NPPES |
| 0815 | Other | PA | BLUE CROSS BLUE SHEILD |
| 459802 | Other | PA | VALUE OPTIONS |
| VO543B | Other | PA | UPMC |
| 0018923880001 | Medicaid | PA | |
| 1018307530003 | Medicaid | PA | |
| 60054 | Other | PA | AETNA |
| 0018923880001 | Other | PA | CCBHO |
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