GATEWAY FOUNDATION INC NPI 1750082194

NPI Information

  • NPI: 1750082194
  • Provider Name: GATEWAY FOUNDATION, INC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • Doing Business As: GATEWAY FOUNDATION, INC
  • Address: 404 N HERSHEY RD STE B
    BLOOMINGTON, IL
    ZIP 61704
  • Phone: (877) 381-6538

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NPI Details

GATEWAY FOUNDATION, INC is a rehabilitation and substance use disorder clinic center in Bloomington, IL. GATEWAY FOUNDATION, INC NPI is 1750082194. The provider is registered as an organization entity type.
The provider Is Doing Business As Gateway Foundation, Inc.

The provider's business location address is:

404 N HERSHEY RD STE B
BLOOMINGTON, IL
ZIP 61704-560
Phone: (877) 381-6538

The provider's authorized official is Jeremy Klemanski .
The authorized official title is Ceo and has the following contact phone number (312) 663-1130.

The enumeration date for this NPI number is 3/13/2023 and was last updated on 8/6/2024.

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
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes
2324500000XSubstance Abuse Rehabilitation FacilityNo

What is NPI?

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This page was last updated on: 11/21/2025

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