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General NPI Number Information
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NPI Number | 1205657335
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Entity Type | Organization
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Legal Business Name | GATEWAY BEHAVIORAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 01/04/2025
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Provider Practice Location Address
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Address Line | 733 THIMBLE SHOALS BLVD STE 170-206
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4260
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Country | US
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Telephone | 804-362-9232
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Fax | 804-414-7560
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Provider Business Mailing Address
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Address Line | PO BOX 2218
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City | POQUOSON
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State | VA
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Zip | 23662-0218
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Country | US
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Telephone | 757-327-8496
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | WILLIAM SPENCER
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Credential |
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Telephone | 804-362-9232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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