Provider Demographics
NPI:1922307883
Name:GATEWAY LIFE HEALTH SERVICES
Entity Type:Organization
Organization Name:GATEWAY LIFE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:RONELL
Authorized Official - Last Name:ACHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-335-7707
Mailing Address - Street 1:PO BOX 181
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-0005
Mailing Address - Country:US
Mailing Address - Phone:281-565-2828
Mailing Address - Fax:281-565-2828
Practice Address - Street 1:18118 RED ASH CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-1975
Practice Address - Country:US
Practice Address - Phone:281-565-2828
Practice Address - Fax:281-565-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health