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GATEWAY TREATMENT CENTERS LLC NPI 1194459883


NPI Information

NPI: 1194459883
Provider Name: GATEWAY TREATMENT CENTERS, LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 11D2168277

Address:
37 KIKER ST
ELLIJAY, GA
ZIP 30540
Phone: (706) 703-2517
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GATEWAY TREATMENT CENTERS, LLC is a clinic center in Ellijay, GA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). GATEWAY TREATMENT CENTERS, LLC NPI is 1194459883. The provider is registered as an organization entity type.

The provider's business location address is:

37 KIKER ST
ELLIJAY, GA
ZIP 30540-758
Phone: (706) 703-2517
Fax: (706) 273-2517

The provider's authorized official is Zachary Charles Talbott .
The authorized official title is President and has the following contact phone number (865) 724-0852.

The CLIA number assigned to this NPI record is 11D2168277 - other - opiod treatment program with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/11/2022 and was last updated on 7/11/2022.


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
1261QM2800XClinic/CenterMethadoneNo
2261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
3261Q00000XClinic/CenterYes

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: 5/5/2024

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