Gaudenzia | |
570 Ritchie Hwy Suite H Severna Park MD 21146-2925 | |
(410) 975-0067 | |
Not Available |
Full Name | Gaudenzia |
---|---|
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 570 Ritchie Hwy, Severna Park, Maryland |
Authorized Official Name and Position | Greg Warren (REGIONAL DIRECTOR) |
Authorized Official Contact | 4103675501 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gaudenzia 3643 Woodland Ave Baltimore MD 21215-5512 Ph: (410) 367-5501 | Gaudenzia 570 Ritchie Hwy Suite H Severna Park MD 21146-2925 Ph: (410) 975-0067 |
NPI Number | 1740652304 |
---|---|
Provider Enumeration Date | 10/22/2015 |
Last Update Date | 10/22/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740652304 | NPI | - | NPPES |
4171233 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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