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General NPI Number Information
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NPI Number | 1457594731
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Entity Type | Organization
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Legal Business Name | GATEWAY ASSISTED LIVING, INC.
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 620 N CLOVERLEAF LOOP
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City | SPRINGFIELD
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State | OR
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Zip | 97477-1167
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Country | US
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Telephone | 541-744-9817
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1848
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City | EUGENE
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State | OR
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Zip | 97440-1848
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Country | US
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Telephone | 541-302-1667
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MS. BARBARA JOAN BRITT
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Credential | MBA
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Telephone | 541-302-1667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 200001
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License Number State | OR
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