Provider Demographics
NPI:1750681821
Name:GATEWAY COMMUNITY SUPPORT SYSTEMS,LLC
Entity Type:Organization
Organization Name:GATEWAY COMMUNITY SUPPORT SYSTEMS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:EXANDRA
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-558-6788
Mailing Address - Street 1:28 SALLIOTTE RD
Mailing Address - Street 2:
Mailing Address - City:ECORSE
Mailing Address - State:MI
Mailing Address - Zip Code:48229-1752
Mailing Address - Country:US
Mailing Address - Phone:888-610-2217
Mailing Address - Fax:734-818-1438
Practice Address - Street 1:28 SALLIOTTE RD
Practice Address - Street 2:
Practice Address - City:ECORSE
Practice Address - State:MI
Practice Address - Zip Code:48229-1752
Practice Address - Country:US
Practice Address - Phone:888-610-2217
Practice Address - Fax:734-818-1438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-23
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care