Healthcare Provider Details

I. General information

NPI: 1649404179
Provider Name (Legal Business Name): GATEKEEPER ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4467 OLD BRANCH AVE STE 103
TEMPLE HILLS MD
20748-1854
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 301-358-6155
  • Fax: 301-423-1440
Mailing address:
  • Phone: 301-358-6155
  • Fax: 301-423-1440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT21443
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. RAPHAEL JOSHUA DENBOW II
Title or Position: OWNER
Credential: PT
Phone: 202-403-7607