Provider Demographics
NPI:1457652885
Name:GATEWAY CENTER OF MONTEREY COUNTY INC.
Entity Type:Organization
Organization Name:GATEWAY CENTER OF MONTEREY COUNTY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-372-8002
Mailing Address - Street 1:850 CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-4811
Mailing Address - Country:US
Mailing Address - Phone:831-372-8002
Mailing Address - Fax:831-372-2411
Practice Address - Street 1:854 CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-4811
Practice Address - Country:US
Practice Address - Phone:831-372-8002
Practice Address - Fax:831-372-2411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities