| Gateway Healthcare, Inc | |
|
160 Beechwood Ave Pawtucket RI 02860-5402 | |
| (401) 722-5573 | |
| (401) 726-5571 |
| Full Name | Gateway Healthcare, Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 160 Beechwood Ave, Pawtucket, Rhode Island |
| Authorized Official Name and Position | Joyce Facteau (CREDENTIALING COORDIANTOR) |
| Authorized Official Contact | 4017248400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Healthcare, Inc 249 Roosevelt Ave Pawtucket RI 02860-2134 Ph: (401) 724-8400 | Gateway Healthcare, Inc 160 Beechwood Ave Pawtucket RI 02860-5402 Ph: (401) 722-5573 |
| NPI Number | 1154351211 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154351211 | NPI | - | NPPES |
| 407707 | Other | RI | BLUE CHIP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | ISW01235 (Rhode Island) | Primary |
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