GATEWAY FOUNDATION INC. NPI 1285883710

NPI Information

NPI: 1285883710
Provider Name: GATEWAY FOUNDATION, INC.
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
25480 W CEDAR CREST LN
LAKE VILLA, IL
ZIP 60046
Phone: (877) 505-4673
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GATEWAY FOUNDATION, INC. is a rehabilitation and substance use disorder clinic center in Lake Villa, IL. GATEWAY FOUNDATION, INC. NPI is 1285883710. The provider is registered as an organization entity type.

The provider's business location address is:

25480 W CEDAR CREST LN
LAKE VILLA, IL
ZIP 60046-744
Phone: (877) 505-4673
Fax: (847) 356-3033

The provider's authorized official is Renee Ennis Mcgee .
The authorized official title is Manager and has the following contact phone number (678) 445-4833.

The enumeration date for this NPI number is 9/9/2008 and was last updated on 12/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	A-0538-0021-A	ILLINOIS	No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	A-0538-0021-A	ILLINOIS	Yes
3	324500000X	Substance Abuse Rehabilitation Facility		C/A-0538-0021-A	ILLINOIS	No
4	3245S0500X	Substance Abuse Rehabilitation Facility	Substance Abuse Treatment, Children	A-0538-0021-A	ILLINOIS	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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