Provider Demographics
NPI:1750412912
Name:GATTO BAY, INC
Entity type:Organization
Organization Name:GATTO BAY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAIVAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:228-363-2022
Mailing Address - Street 1:PO BOX 3367
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39505-3367
Mailing Address - Country:US
Mailing Address - Phone:228-832-0556
Mailing Address - Fax:228-831-4495
Practice Address - Street 1:127 GARY ST
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3503
Practice Address - Country:US
Practice Address - Phone:228-832-0556
Practice Address - Fax:228-831-4495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty