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General NPI Number Information
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NPI Number | 1962286120
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Entity Type | Organization
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Legal Business Name | GATEWAYS TO COMMITMENT
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 3143 ZION ST
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City | RICHMOND
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State | VA
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Zip | 23234-1640
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Country | US
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Telephone | 804-307-0668
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Fax |
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Provider Business Mailing Address
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Address Line | 4313 TOSH LN
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City | CHESTER
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State | VA
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Zip | 23831-6855
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Country | US
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Telephone | 804-307-0668
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | RENARD LAVELL COX
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Credential |
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Telephone | 804-617-0969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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