Healthcare Provider Details

I. General information

NPI: 1770616104
Provider Name (Legal Business Name): GATEWAY BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 PALMETTO BAY RD
SAVANNAH GA
31410-2642
US

IV. Provider business mailing address

1000 COMMISSIONER DR
DARIEN GA
31305-9487
US

V. Phone/Fax

Practice location:
  • Phone: 912-437-7300
  • Fax: 912-437-9481
Mailing address:
  • Phone: 912-437-7300
  • Fax: 912-437-9481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateGA

VIII. Authorized Official

Name: DR. FRANK BONATI
Title or Position: CEO
Credential: MD
Phone: 912-437-7300