Healthcare Provider Details

I. General information

NPI: 1023014271
Provider Name (Legal Business Name): GATEWAY HEALTH CARE CENTRES LIMITED PTR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 GATEWAY DRIVE
EUCLID OH
44119-2447
US

IV. Provider business mailing address

23530 SAINT CLAIR AVE
EUCLID OH
44117-2513
US

V. Phone/Fax

Practice location:
  • Phone: 216-486-4949
  • Fax: 216-481-5155
Mailing address:
  • Phone: 216-486-4949
  • Fax: 216-481-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number5082
License Number StateOH

VIII. Authorized Official

Name: MRS. BETH DECAPITE
Title or Position: MANAGING MEMBER
Credential:
Phone: 216-486-4949