Provider Demographics
NPI:1912207267
Name:GATE OF RECOVERY, INC.
Entity Type:Organization
Organization Name:GATE OF RECOVERY, INC.
Other - Org Name:VANTAGE POINT RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MINOO
Authorized Official - Middle Name:
Authorized Official - Last Name:SHILATI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-777-7595
Mailing Address - Street 1:123 HODENCAMP RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5896
Mailing Address - Country:US
Mailing Address - Phone:805-777-7595
Mailing Address - Fax:805-777-9249
Practice Address - Street 1:123 HODENCAMP RD
Practice Address - Street 2:SUITE 205
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5896
Practice Address - Country:US
Practice Address - Phone:805-777-7595
Practice Address - Fax:805-777-9249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 45424101Y00000X
CALMFT#45424106H00000X
CA560045AP261QM0850X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder