Provider Demographics
NPI:1184736324
Name:GATEWAY COMMUNITY SERVICES
Entity type:Organization
Organization Name:GATEWAY COMMUNITY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTS/ BILLINGS
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:K
Authorized Official - Last Name:HAYWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-727-2512
Mailing Address - Street 1:26 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3106
Mailing Address - Country:US
Mailing Address - Phone:406-727-2512
Mailing Address - Fax:406-727-7451
Practice Address - Street 1:26 4TH ST N
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3106
Practice Address - Country:US
Practice Address - Phone:406-727-2512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT227101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT075111OtherBLUE CROSS/BLUE SHIELD
MT0320034Medicaid
MT0320034Medicaid