Healthcare Provider Details

I. General information

NPI: 1538544382
Provider Name (Legal Business Name): GATEKEEPER ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4640 FORBES BLVD STE 203
LANHAM MD
20706-4885
US

IV. Provider business mailing address

4255 ALTAMONT PL STE 201
WHITE PLAINS MD
20695-3024
US

V. Phone/Fax

Practice location:
  • Phone: 240-467-5732
  • Fax:
Mailing address:
  • Phone: 240-467-5732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number21443
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. RAPHAEL J DENBOW
Title or Position: CEO/OWNER
Credential: DPT
Phone: 301-358-6155