| Gaudenzia Glen Burnie | |
|
5 Crain Hwy N Glen Burnie MD 21061-2803 | |
| (443) 569-7950 | |
| (410) 787-8380 |
| Full Name | Gaudenzia Glen Burnie |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5 Crain Hwy N, Glen Burnie, Maryland |
| Authorized Official Name and Position | Mike Williams (SR. CONTRACT MANAGER) |
| Authorized Official Contact | 4843383731 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaudenzia Glen Burnie 106 W Main St Norristown PA 19401-4716 Ph: (610) 239-9600 | Gaudenzia Glen Burnie 5 Crain Hwy N Glen Burnie MD 21061-2803 Ph: (443) 569-7950 |
| NPI Number | 1194455477 |
|---|---|
| Provider Enumeration Date | 06/10/2022 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194455477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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