Provider Demographics
NPI:1598292997
Name:GATEWAY ASSISTED LIVING, INC.
Entity Type:Organization
Organization Name:GATEWAY ASSISTED LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIALOFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-302-1667
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1848
Mailing Address - Country:US
Mailing Address - Phone:541-302-1667
Mailing Address - Fax:541-302-1339
Practice Address - Street 1:611 N CLOVERLEAF LOOP
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-1188
Practice Address - Country:US
Practice Address - Phone:541-774-9817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1851896642311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR570965Medicaid
OR502107Medicaid
OR527211Medicaid
OR527211Medicaid
OR515388Medicaid