Provider Demographics
NPI:1265700538
Name:GATEWAY SUPPORT SERVICES
Entity type:Organization
Organization Name:GATEWAY SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:440-466-3942
Mailing Address - Street 1:20 FAIRVIEW RD
Mailing Address - Street 2:P.O. BOX 207
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-7118
Mailing Address - Country:US
Mailing Address - Phone:440-466-3942
Mailing Address - Fax:440-466-0485
Practice Address - Street 1:20 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-7118
Practice Address - Country:US
Practice Address - Phone:440-466-3942
Practice Address - Fax:440-466-0485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services