Provider Demographics
NPI:1487179057
Name:GATEWAY FOUNDATION, INC.
Entity Type:Organization
Organization Name:GATEWAY FOUNDATION, INC.
Other - Org Name:GFI SERVICES. INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACT AND CRED SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LATINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-663-1130
Mailing Address - Street 1:55 E JACKSON BLVD STE 1500
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-4184
Mailing Address - Country:US
Mailing Address - Phone:312-663-1130
Mailing Address - Fax:312-663-0504
Practice Address - Street 1:1430 OLIVE ST STE 300
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-2303
Practice Address - Country:US
Practice Address - Phone:314-721-6188
Practice Address - Fax:314-421-5994
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GATEWAY FOUNDATION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-04
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder