GAUDENZIA, INC. (NPI# 1295181170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295181170 |
| Entity Type | Organization |
| Organization Name | GAUDENZIA, INC. |
| Other Organization Name | GAUDENZIA - GLEN BURNIE OUTPATIENT |
| Practice Address |
5 Crain Highway North - Rear Suite Entrance Glen Burnie MD 21061 |
| Mailing Address |
3643 Woodland Ave Baltimore MD 21215-5512 |
| Practice Telephone | 4435697950 |
| Practice Fax Number | 4103671810 |
| Mailing Telephone | (410) 864-0674 |
| Mailing Fax Number | 4103671810 |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2017-06-26 |
| Authorized Official Name | CHANDRA MCNEIL-JOHNSON (FINANCE MANAGER) |
| Authorized Official Telephone | 4108640674 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Gaudenzia - Glen Burnie Outpatient | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972061497 | Gaudenzia, Inc. | Clinic/Center | 105 Circle Drive, Crownsville, MD 21032-2061 | 2019-03-04 |
| 1932650744 | Gaudenzia, Inc. | Substance Abuse Rehabilitation Facility | 4613 Park Heights Ave, Baltimore, MD 21215-6339 | 2016-10-17 |
| 1558352872 | Gaudenzia, Inc. | Substance Abuse Rehabilitation Facility | 106 W Main St, Norristown, PA 19401-4716 | 2005-11-04 |
| 1750755351 | Gaudenzia, Inc. | Substance Abuse Rehabilitation Facility | 107 Circle Dr, Crownsville, MD 21032-2061 | 2015-11-19 |
| 1700051356 | Gaudenzia, Inc. | Clinic/Center | 166 W Main St, Norristown, PA 19401-4716 | 2008-04-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GAUDENZIA, INC. | 106 W Main St, Norristown, PA 19401-4716 |
| Street Address |
5 CRAIN HIGHWAY NORTH - REAR SUITE ENTRANCE |
| City | GLEN BURNIE |
| State | MD |
| Zip Code | 21061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255814422 | Lotus Behavioral Health and Rehabilitation Services Inc. | Behavior Technician | 6426 Harrison Square, Glen Burnie, MD 21061 | 2018-09-12 |
| 1942795315 | Tina Brown | Behavior Technician | Rise for Autism, 510 Mccormick Drive, Ste. U-w, Glen Burnie, MD 21061 | 2018-06-27 |
| 1205351905 | Digna Emerita Sanchez De Vasquez | Specialist/Technologist, Other | 201 Fernglen Ave, Glen Burnie, MD 21061 | 2017-08-03 |
| 1255780300 | Rachel Cutts | Physical Therapist | 7711 Quarterfield Rd Ste C2, Glen Burnie, MD 21061 | 2016-06-09 |
| 1023499548 | Mary Bourbon | Nurse Practitioner | 1600 S. Cain Highway, Suite 401, Glen Burnie, MD 21061 | 2015-06-10 |
| 1972997724 | Robert Oladeinde | Physician Assistant | 6934 Aviation Blvd Suite B, Glen Burnie, MD 21061 | 2015-03-18 |
| 1205248069 | Cathy Qing He | Anesthesiology | 1600 Crain Hwy S Ste 301, Glen Burnie, MD 21061 | 2014-05-28 |
| 1477974764 | Shannon Holder | Nurse Practitioner | 1916 Crain Hwy S Ste 2, Glen Burnie, MD 21061 | 2014-01-03 |
| 1629404207 | Marla Ann Muha | Physician Assistant | 301 Hospital Dr # 803, Glen Burnie, MD 21061 | 2013-09-16 |
| 1902142839 | Behavioral Healthcare of Maryland | Clinic/Center | 1405 Madison Park Drive Suite 1b, Glen Burnie, MD 21061 | 2012-12-21 |
| Find all providers in zip 21061 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568096428 | Issiaih House 1 | Counselor | 2301 Dorsey Rd, Glen Burnie, MD 21061-3299 | 2020-02-28 |
| 1205460284 | Issiaih House 1 | Counselor | 1406b Crain Hwy S Ste 201, Glen Burnie, MD 21061-4336 | 2020-02-27 |
| 1326605858 | Wellness Rx Corporation | Counselor | 7310 Ritchie Hwy Ste 512, Glen Burnie, MD 21061-3099 | 2019-05-21 |
| 1134661077 | Stephanie Campbell | Counselor | 1412 Crain Hwy N Ste 1b, Glen Burnie, MD 21061-9306 | 2016-11-09 |
| 1538400775 | James Steffan Collins IIi | Counselor | 1410 Crain Hwy N Ste 5b, Glen Burnie, MD 21061-9304 | 2013-03-13 |
| 1417197310 | Leon Flemembaum | Counselor | 550 Crain Hwy N Ste 8, Glen Burnie, MD 21061-3057 | 2009-03-05 |
| 1801912225 | Alcohol & Drug Intervention | Counselor | 7458 B A Blvd, Glen Burnie, MD 21061 | 2007-03-21 |
| 1568599637 | Recovery Resources Group | Counselor | 2 B Crain Highway Sw, Glen Burnie, MD 21061 | 2007-02-27 |
| 1801945001 | Clean and Sober | Counselor | 8 Crain Hwy N, Unit C, Glen Burnie, MD 21061-3559 | 2007-01-09 |
| 1083763486 | Grant Steven James | Counselor | 1603 Kimber Rd, Glen Burnie, MD 21060-7410 | 2007-01-09 |
| Find all providers in GLEN BURNIE | ||||
| City | GLEN BURNIE |
| Zip Code | 21061 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.