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General NPI Number Information
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NPI Number | 1265755409
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Entity Type | Organization
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Legal Business Name | GATEWAY PROPERTIES & RESTORATIONS,LLC
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 3015 HERITAGE RD NE SUITE 8
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-8201
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Country | US
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Telephone | 478-454-5408
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Fax | 478-804-9949
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Provider Business Mailing Address
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Address Line | 2286 PRINCE CT
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-2070
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Country | US
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Telephone | 478-454-5408
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Fax | 478-804-9949
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. ANGELA NICOLE WILLIAMS
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Credential |
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Telephone | 478-491-3047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 005-R-0913
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License Number State | GA
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