NPIMap

Organization Active NPI

Gateway Behavioral Health Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Brunswick, GA
National Provider Identifier
1124151980
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
GATEWAY BEHAVIORAL HEALTH SERVICES
Practice address
107 Baybridge Dr
Brunswick, GA 31525-1818
Phone
(912) 264-6065
Fax
(912) 265-4520
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Authorized official

Name
Mr. William Parks, CPA CFO
Title
Chief Financial Officer
Phone
(912) 554-8464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

107 Baybridge Dr
Brunswick, GA 31525-1818

Mailing address

700 Coastal Village Dr
Brunswick, GA 31520-1974
Phone (912) 264-0979

Other identifiers 1

IdentifierTypeStateIssuer
000622553AVMedicaidGA

Other names 1

  • Gateway BHS - Glynn Paton GH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gateway Community Service Board72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1124151980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 COASTAL VILLAGE DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315201974",
            "telephone_number": "912-264-0979",
            "fax_number": "912-264-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BAYBRIDGE DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315251818",
            "telephone_number": "912-264-6065",
            "fax_number": "912-265-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "912-554-8464",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA CFO"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000622553AV",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway BHS - Glynn Paton GH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.