MEDICARE: GATEWAYS TO CHANGE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency	13	RI

General Provider Information

NPI Number	:	1083748560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAYS TO CHANGE, INC

Provider Business Mailing Address
First Line	:	11 KNIGHT ST
Second Line	:	BLDG B6
City	:	WARWICK
State	:	RI
Zip	:	02886-1281
Country	:	US
Telephone Number	:	401-463-0000
Fax Number	:	401-463-0010

Provider Business Practice Location Address
First Line	:	397 GREENVILLE RD
Second Line	:
City	:	NORTH SMITHFIELD
State	:	RI
Zip	:	02896-8109
Country	:	US
Telephone Number	:	401-463-0000
Fax Number	:	401-463-0010

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. CATHERINE MCGILLIVRAY
Credential	:
Telephone Number	:	401-463-0000

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/22/2020

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Directions to “GATEWAYS TO CHANGE, INC ” Practice Location

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