Provider Demographics
NPI:1861846693
Name:GATEWAY HOME HEALTH CORP.
Entity Type:Organization
Organization Name:GATEWAY HOME HEALTH CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO / ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:S
Authorized Official - Last Name:KEHRET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-322-4455
Mailing Address - Street 1:10 CROW CANYON CT STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1980
Mailing Address - Country:US
Mailing Address - Phone:925-322-4455
Mailing Address - Fax:888-816-0197
Practice Address - Street 1:10 CROW CANYON CT STE 210
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1980
Practice Address - Country:US
Practice Address - Phone:925-322-4455
Practice Address - Fax:888-816-0197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC3875187251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health