Healthcare Provider Details

I. General information

NPI: 1578099727
Provider Name (Legal Business Name): GATEWAY HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2017
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 N WARSON RD SUITE 115
SAINT LOUIS MO
63132-1111
US

IV. Provider business mailing address

1515 N WARSON RD SUITE 115
SAINT LOUIS MO
63132-1111
US

V. Phone/Fax

Practice location:
  • Phone: 800-240-6976
  • Fax:
Mailing address:
  • Phone: 800-240-6976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISEVANS STEVENSON
Title or Position: SENIOR COMMUNITY LIAISON
Credential:
Phone: 800-240-6976