Gateway Center of Monterey Co Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

GATEWAY CENTER OF MONTEREY CO INC

Practice address

840 Congress Ave
Pacific Grove, CA 93950-4811

Phone

(831) 372-8002

Fax

(831) 372-2411

NPI assigned

May 6, 2016

Organization subpart

Yes

Parent organization

GATEWAY CENTER MONTEREY COUNTY INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Stephanie Lyon

Title

Executive Director

Phone

(831) 372-8002

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G760

Legal name

GATEWAY CENTER ICF2

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Dec 5, 2017

Last certification

Sep 20, 2024

Beds

15

Ownership / control type

Private (non-profit)

Facility address

840 Congress Avenue
Pacific Grove, CA 93950

Tax ID family

Gateway Center of Monterey Co Inc2 organizations share this tax ID, including this one

Part of

Gateway Center of Monterey Co Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gateway Center of Monterey County Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Pacific Grove, CA
  • NPI 1457652885
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Gateway Center of Monterey County Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Pacific Grove, CA
  • NPI 1457652885
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1003262239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 CONGRESS AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939504811",
            "telephone_number": "831-372-8002",
            "fax_number": "831-372-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 CONGRESS AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939504811",
            "telephone_number": "831-372-8002",
            "fax_number": "831-372-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY CENTER OF MONTEREY CO INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GATEWAY CENTER MONTEREY COUNTY INC.",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "LYON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "831-372-8002",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457652885",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert M Fontecchio
• Front Porch Communities and Services
• Andrea Fuller, MFT
• Amie Rovane Gahan, DPT
• Elisa Garcia, ELISA GARCIA, OTR/L
• Gateway Center of Monterey County Inc.
• Sylvia Gil
• Trinette Louise Gilbert, D.C.
• Jane Ann Gingerich, L,C.S.W.
• Martha Elizabeth Gleason, PHD

• Intellectual Disabilities Intermediate Care Facility in Pacific Grove, CA
• Providers in Pacific Grove, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.