Provider Demographics
NPI:1508187691
Name:SOLUTIONS FOR SPECIAL NEEDS PSR CENTER
Entity Type:Organization
Organization Name:SOLUTIONS FOR SPECIAL NEEDS PSR CENTER
Other - Org Name:GATEWAY MARKETING LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMEA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTTY
Authorized Official - Suffix:
Authorized Official - Credentials:PSR INSTRUCTOR
Authorized Official - Phone:505-699-0919
Mailing Address - Street 1:223 N GUADALUPE ST # 159
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-1868
Mailing Address - Country:US
Mailing Address - Phone:505-699-0919
Mailing Address - Fax:
Practice Address - Street 1:8 CENTAURUS RANCH RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-7912
Practice Address - Country:US
Practice Address - Phone:505-699-0919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GATEWAY MARKETING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-12
Last Update Date:2010-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty