Gateway Community Services, Inc. | |
2133 Broadway Ave Jacksonville FL 32209-7513 | |
(904) 361-5010 | |
(904) 384-2299 |
Full Name | Gateway Community Services, Inc. |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 2133 Broadway Ave, Jacksonville, Florida |
Authorized Official Name and Position | Laura Dale (CFO) |
Authorized Official Contact | 9043874661 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gateway Community Services, Inc. 555 Stockton St Jacksonville FL 32204-2534 Ph: (904) 387-4661 | Gateway Community Services, Inc. 2133 Broadway Ave Jacksonville FL 32209-7513 Ph: (904) 361-5010 |
NPI Number | 1124783477 |
---|---|
Provider Enumeration Date | 11/02/2021 |
Last Update Date | 05/13/2022 |
Certification Date | 05/13/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124783477 | NPI | - | NPPES |
1659541654 | Other | FL | NPI |
1619411279 | Other | FL | NPI |
1689252314 | Other | FL | NPI |
1811393499 | Other | FL | NPI |
1316376585 | Other | FL | NPI |
1427184308 | Other | FL | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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