Provider Demographics
NPI:1649249384
Name:ARC GATEWAY, INC.
Entity type:Organization
Organization Name:ARC GATEWAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-434-2638
Mailing Address - Street 1:3932 N. 1OTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503
Mailing Address - Country:US
Mailing Address - Phone:850-434-2638
Mailing Address - Fax:850-438-2180
Practice Address - Street 1:3932 N. 1OTH AVENUE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503
Practice Address - Country:US
Practice Address - Phone:850-434-2638
Practice Address - Fax:850-438-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services