Provider Demographics
NPI:1356897649
Name:GATEWAY BEHAVIVORAL HEALTH SERVICES
Entity type:Organization
Organization Name:GATEWAY BEHAVIVORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-554-8490
Mailing Address - Street 1:700 COASTAL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-1974
Mailing Address - Country:US
Mailing Address - Phone:912-554-8490
Mailing Address - Fax:912-265-2683
Practice Address - Street 1:6129 NEW JESUP HWY
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-1974
Practice Address - Country:US
Practice Address - Phone:912-554-8490
Practice Address - Fax:912-265-2683
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GATEWAY BEHAVIORAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health