MEDICARE: GATEWAY HEALTHCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	RI633	RI
2	261QM1300X	Multi-Specialty Clinic/Center	RI633	RI
3	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
4	251S00000X	Community/Behavioral Health Agency	RI633	RI
5	324500000X	Substance Abuse Rehabilitation Facility
6	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	RI633	RI
7	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	RI633	RI

General Provider Information

NPI Number	:	1821078932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY HEALTHCARE INC

Provider Business Mailing Address
First Line	:	15 LA SALLE SQ
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02903-1814
Country	:	US
Telephone Number	:	401-724-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	101-103 BACON ST
Second Line	:
City	:	PAWTUCKET
State	:	RI
Zip	:	02860-5542
Country	:	US
Telephone Number	:	401-722-3560
Fax Number	:	401-722-3593

Authorized Official
Title or Position	:	EVP & CFO
Name	:	PETER K MARKELL
Credential	:
Telephone Number	:	401-444-7914

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	12/10/2025

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Directions to “GATEWAY HEALTHCARE INC ” Practice Location

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