Provider Demographics
NPI:1003377011
Name:GATEWAY RECOVERY CLINIC, PLLC
Entity type:Organization
Organization Name:GATEWAY RECOVERY CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:859-432-8002
Mailing Address - Street 1:805 ALEXA DR STE D
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1000
Mailing Address - Country:US
Mailing Address - Phone:859-432-8002
Mailing Address - Fax:
Practice Address - Street 1:805 ALEXA DR STE D
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1000
Practice Address - Country:US
Practice Address - Phone:859-432-8002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-31
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty