Healthcare Provider Details

I. General information

NPI: 1841593332
Provider Name (Legal Business Name): GATEWAY-LONGVIEW, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5360 GENESEE ST
BOWMANSVILLE NY
14026-1044
US

IV. Provider business mailing address

5360 GENESEE ST
BOWMANSVILLE NY
14026-1044
US

V. Phone/Fax

Practice location:
  • Phone: 716-781-3138
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number0053741
License Number StateNY

VIII. Authorized Official

Name: MRS. JANET MARIE SCHULTZ MORELOCK
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: MA, CCC-SLP, NYS LIC
Phone: 716-773-3238