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General NPI Number Information
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NPI Number | 1881917052
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Entity Type | Organization
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Legal Business Name | THE GATEWAY RESIDENTIAL TREATMENT CENTER
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 15117 ALMEDA SCHOOL RD
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City | HOUSTON
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State | TX
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Zip | 77047-7129
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Country | US
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Telephone | 713-413-1400
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Fax | 713-413-2110
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Provider Business Mailing Address
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Address Line | 15117 ALMEDA SCHOOL RD
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City | HOUSTON
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State | TX
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Zip | 77047-7129
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Country | US
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Telephone | 713-413-1400
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Fax | 713-413-2110
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/CEO
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Name | MS. CLAUDIA JEAN BLAKEMORE
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Credential | RN
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Telephone | 713-413-1400
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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 | 963426
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License Number State | TX
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