Provider Demographics
NPI:1841727617
Name:GATEWAY GARDENS ASSISTED LIVING, INC.
Entity type:Organization
Organization Name:GATEWAY GARDENS ASSISTED LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-023-1667
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1848
Mailing Address - Country:US
Mailing Address - Phone:541-302-1667
Mailing Address - Fax:541-302-1339
Practice Address - Street 1:178 COMMONS DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8923
Practice Address - Country:US
Practice Address - Phone:541-302-1283
Practice Address - Fax:541-302-1339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1881328760311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR513856Medicaid
OR513856Medicaid