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General NPI Number Information
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NPI Number | 1306478599
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Entity Type | Organization
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Legal Business Name | GATEWAY TREATMENT CENTER
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 02/06/2020
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Provider Practice Location Address
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Address Line | 1034 GATEWAY BLVD STE 104
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8360
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Country | US
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Telephone | 561-685-6934
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Fax |
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Provider Business Mailing Address
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Address Line | 1034 GATEWAY BLVD STE 104
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8360
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Country | US
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Telephone | 561-685-6934
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | ADAM COLLING
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Credential |
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Telephone | 561-685-6934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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