GATEWAY COMMUNITY SERVICES INC NPI 1356305338

NPI Information

NPI: 1356305338
Provider Name: GATEWAY COMMUNITY SERVICES INC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 10D1037601

Address:
555 STOCKTON ST
JACKSONVILLE, FL
ZIP 32204
Phone: (904) 387-4661
Get Directions

GATEWAY COMMUNITY SERVICES INC is a substance abuse rehabilitation facility in Jacksonville, FL. The provider is 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. GATEWAY COMMUNITY SERVICES INC NPI is 1356305338. The provider is registered as an organization entity type.

The provider's business location address is:

555 STOCKTON ST
JACKSONVILLE, FL
ZIP 32204-534
Phone: (904) 387-4661
Fax: (904) 384-5753

The provider's authorized official is Laura Dale .
The authorized official title is Cfo and has the following contact phone number (904) 387-4661.

The CLIA number assigned to this NPI record is 10D1037601 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/14/2006 and was last updated on 11/2/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			No
2	324500000X	Substance Abuse Rehabilitation Facility		0416AD182816	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	060594800	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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