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GAUDENZIA PARK HEIGHTS
NPI 1093235954
Substance Abuse Rehabilitation Facility in Baltimore, MD

Active since June 22, 2017CLIA Certified · 3 labs
4615 PARK HEIGHTS AVE, BALTIMORE, MD 21215(443) 423-1500(443) 423-1596 Get Directions Write a Review

NPPES record last updated: February 13, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 13, 2023, Jun 24, 2021, Apr 26, 2021 and 1 more (4 updates tracked since 2017).

About Gaudenzia Park Heights NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GAUDENZIA PARK HEIGHTS (NPI 1093235954) is a healthcare organization registered as a substance abuse rehabilitation facility in Baltimore, Maryland and active in the NPI registry since June 2017. The organization holds 3 active CLIA laboratory certificates and lists Youthful Edrington, Credential Specialist, as its authorized official.

NPPES Registry Identity

NPI1093235954
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameGAUDENZIA INC
Location Address4615 PARK HEIGHTS AVEBaltimore, MD 21215-6331
Mailing Address106 W Main StNorristown, PA 19401-4716 · (610) 239-9600 · Fax (610) 275-7025
Phone(443) 423-1500
Fax(443) 423-1596
Organization SubpartNo
Authorized OfficialYouthful EdringtonCredential Specialist · (717) 980-1519
Enumeration DateJune 22, 2017
Last NPPES UpdateFebruary 13, 20234 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2023
✔ NPI 1093235954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
4615 PARK HEIGHTS AVE, Baltimore, MD 21215
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Other Names 1

Other NameGaudenzia Park Heights

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2204823

Gaudenzia Inc Park Heights · Baltimore, MD
Active · expires Dec 9, 2026
CLIA Number21D2204823
Laboratory TypeResidential Tx
Certificate Effective DateDecember 10, 2024
Certificate Expiration DateDecember 9, 2026
Laboratory DirectorMary Lilly
Laboratory Phone(443) 681-0776
Laboratory LocationGaudenzia Inc Park Heights4615 Park Heights Ave, Baltimore, MD 21215
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2204820

Gaudenzia Inc Woodland · Baltimore, MD
Active · expires Dec 9, 2026
CLIA Number21D2204820
Laboratory TypeResidential Tx
Certificate Effective DateDecember 10, 2024
Certificate Expiration DateDecember 9, 2026
Laboratory DirectorMary Lilly
Laboratory Phone(443) 681-0776
Laboratory LocationGaudenzia Inc Woodland3643 Woodland Ave, Baltimore, MD 21215
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2204832

Gaudenzia Inc Park Heights Weinburg · Baltimore, MD
Active · expires Dec 9, 2026
CLIA Number21D2204832
Laboratory TypeResidential Tx
Certificate Effective DateDecember 10, 2024
Certificate Expiration DateDecember 9, 2026
Laboratory DirectorMary Lilly
Laboratory Phone(443) 681-0776
Laboratory LocationGaudenzia Inc Park Heights Weinburg4613 Park Heights Ave, Baltimore, MD 21215
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLUSEYI IGE OGUNDANA CRNP
Nurse Practitioner (Family)
4615 PARK HEIGHTS AVE
BALTIMORE, MD 21215
Baltimore City (240) 413-5721
GAUDENZIA
Substance Abuse Rehabilitation Facility
4615 PARK HEIGHTS AVE
BALTIMORE, MD 21215
Baltimore City (443) 423-1500
CHRISTIANA OLUWAKEMI OLAYERA-AKINBOYE NP
Nurse Practitioner (Psychiatric/Mental Health)
4615 PARK HEIGHTS AVE
BALTIMORE, MD 21215
Baltimore City (443) 423-1500
GAUDENZIA INC
Clinic/Center
4615 PARK HEIGHTS AVE
BALTIMORE, MD 21215
Baltimore City (443) 423-1500
GAUDENZIA.ORG
Substance Abuse Rehabilitation Facility
4615 PARK HEIGHTS AVE
BALTIMORE, MD 21215
Baltimore City (410) 367-4447
GAUDENZIA, INC.
Substance Abuse Rehabilitation Facility
4615 PARK HEIGHTS AVE
BALTIMORE, MD 21215
Baltimore City (443) 423-1500
GAUDENZIA, INC
Community/Behavioral Health
4615 PARK HEIGHTS AVE
BALTIMORE, MD 21215
Baltimore City (443) 423-1500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gaudenzia Inc's NPI number?

The NPI number for Gaudenzia Inc is 1093235954. It was assigned to this organization in the NPPES registry on June 22, 2017. The provider is also known as Gaudenzia Park Heights.

Where is Gaudenzia Inc located?

Gaudenzia Inc is located at 4615 Park Heights Ave, Baltimore, MD 21215. The listed phone number is (443) 423-1500.

What is Gaudenzia Inc's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Gaudenzia Inc hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Gaudenzia Inc was last updated on February 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.