Provider Demographics
NPI:1881728566
Name:GATEWAYS TO CHANGE, INC.
Entity type:Organization
Organization Name:GATEWAYS TO CHANGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGILLIVRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-463-0000
Mailing Address - Street 1:11 KNIGHT ST
Mailing Address - Street 2:BLDG B6
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1281
Mailing Address - Country:US
Mailing Address - Phone:401-463-0000
Mailing Address - Fax:401-463-0010
Practice Address - Street 1:11 KNIGHT ST
Practice Address - Street 2:BLDG B6
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1281
Practice Address - Country:US
Practice Address - Phone:401-463-0000
Practice Address - Fax:401-463-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI56251J00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGC55234Medicaid