MEDICARE: GATEWAY REHABILITATION CENTER-GREENTREE

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	707121	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891796413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY REHABILITATION CENTER-GREENTREE

Provider Business Mailing Address
First Line	:	311 ROUSER RD
Second Line	:
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-2719
Country	:	US
Telephone Number	:	412-604-8900
Fax Number	:	412-299-8751

Provider Business Practice Location Address
First Line	:	1016 GREENTREE RD
Second Line	:	SUITE 300
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-3100
Country	:	US
Telephone Number	:	412-928-5940
Fax Number	:	412-928-5947

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. JAMES TROUP
Credential	:
Telephone Number	:	412-604-8900

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	06/03/2022

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Directions to “GATEWAY REHABILITATION CENTER-GREENTREE ” Practice Location

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