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NPI Code Detail

MEDICARE: GATEWAY BEHAVIORAL HEALTH SERVICES

MEDICARE: GATEWAY BEHAVIORAL HEALTH SERVICES
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
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740319359
Entity Type Code : Organization
Provider Name (Legal Business Name) : GATEWAY BEHAVIORAL HEALTH SERVICES
Provider Business Mailing Address
First Line : 700 COASTAL VILLAGE DR
Second Line :
City : BRUNSWICK
State : GA
Zip : 31520-1974
Country : US
Telephone Number : 912-264-0979
Fax Number : 912-264-5965
Provider Business Practice Location Address
First Line : 1113 E OGLETHORPE HWY
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-1200
Country : US
Telephone Number : 912-368-3502
Fax Number : 912-368-6844
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MR. WILLIAM PARKS
Credential : CFO
Telephone Number : 912-554-8464
Provider Enumeration Date : 03/02/2007
Last Update Date : 09/27/2011

Similar Medicare Providers

1235536533 — KYLE SANDERS-JEFFERSON NURSE PRACTITIONER
Practice Location Address:
1113 E OGLETHORPE HWY
HINESVILLE, GA
31313-1200
Practice Phone: 912-876-2173
Practice Fax: 912-876-2346
1407839061 — LIBERTY COUNTY BOARD OF HEALTH
Practice Location Address:
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HINESVILLE, GA
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Practice Fax: 912-368-8033
1205878428 — LINDA FAGAN NP
Practice Location Address:
1113 E OGLETHORPE HWY
HINESVILLE, GA
31313-1200
Practice Phone: 912-876-2173
Practice Fax: 912-368-8033
1245546704 — LIBERTY COUNTY BOARD OF HEALTH
Practice Location Address:
1113 E OGLETHORPE HWY
HINESVILLE, GA
31313-1200
Practice Phone: 912-876-2173
Practice Fax: 912-368-8033
1699065789 — SANDRA HERRERA LPN
Practice Location Address:
1113 E OGLETHORPE HWY
HINESVILLE, GA
31313-1200
Practice Phone: 912-368-3502
Practice Fax: 912-368-6844
1275937807 — COASTAL HEALTH DISTRICT
Practice Location Address:
1113 E OGLETHORPE HWY
HINESVILLE, GA
31313-1200
Practice Phone: 912-876-2173
Practice Fax: 912-368-8033

Directions to “GATEWAY BEHAVIORAL HEALTH SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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