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General NPI Number Information
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NPI Number | 1033248257
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Entity Type | Organization
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Legal Business Name | GATEWAYS HOSPITAL AND MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 1338 S GRAND AVE
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City | LOS ANGELES
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State | CA
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Zip | 90015-3009
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Country | US
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Telephone | 213-389-5820
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Fax |
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Provider Business Mailing Address
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Address Line | 1891 EFFIE STREET
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City | LOS ANGELES
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State | CA
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Zip | 90026
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Country | US
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Telephone | 323-644-2000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARA PELSMAN
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Credential |
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Telephone | 323-644-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 930000058
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License Number State | CA
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