Provider Demographics
NPI:1952025314
Name:GATEWAY ASSISTED LIVING LLC
Entity type:Organization
Organization Name:GATEWAY ASSISTED LIVING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:DIXON-SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-429-7818
Mailing Address - Street 1:4108 WEST HUNDRED ROAD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-2165
Mailing Address - Country:US
Mailing Address - Phone:804-429-7818
Mailing Address - Fax:804-621-4467
Practice Address - Street 1:4108 WEST HUNDRED ROAD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-2165
Practice Address - Country:US
Practice Address - Phone:804-429-7818
Practice Address - Fax:804-621-4467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care