Provider Demographics
NPI:1942403696
Name:GATEWAY HOUSE INC
Entity Type:Organization
Organization Name:GATEWAY HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:LADAC
Authorized Official - Phone:479-783-8849
Mailing Address - Street 1:3900 ARMOUR AVENUE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72904-4317
Mailing Address - Country:US
Mailing Address - Phone:479-783-8849
Mailing Address - Fax:479-782-5682
Practice Address - Street 1:3900 ARMOUR AVENUE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72904-4317
Practice Address - Country:US
Practice Address - Phone:479-783-8849
Practice Address - Fax:479-782-5682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR00001261QR0405X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Not Answered324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility