NPIMap

Organization Active NPI

Gateway Foundation, Inc.

  • Substance Abuse Rehabilitation Facility
  • Carbondale, IL
National Provider Identifier
1235420019
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
A-0538-0043-A Issued in IL
Legal business name
GATEWAY FOUNDATION, INC.
Practice address
1080 E. Park Street
1St Floor, North
Carbondale, IL 62901
Phone
(618) 529-1151
Fax
(618) 549-9540
NPI assigned
Apr 27, 2011
Last updated
Dec 16, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GATEWAY FOUNDATION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Authorized official

Name
Mr. Thomas P. Britton
Title
President & Ceo
Phone
(312) 663-1130

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-0538-0043-A
Substance Abuse Rehabilitation Facility 324500000X A-0538-0043-A IL Primary

Addresses

Primary practice location

1080 E. Park Street
1St Floor, North
Carbondale, IL 62901

Mailing address

55 E. Jackson Blvd.
Suite 1500
Chicago, IL 60604
Phone (312) 663-1130

National Provider Directory

National Provider Directory
Tax ID family
Gateway Foundation Inc - BHC45 organizations share this tax ID, including this one
Part of
Gateway Foundation Inc - BHC

Other organizations with this tax ID 44

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

View all 44

Locations

1080 E Park St
Fl 1
Carbondale, IL 62901
Phone (618) 529-1151

NPI Registry JSON

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1235420019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E. JACKSON BLVD.",
            "address_2": "SUITE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60604",
            "telephone_number": "312-663-1130",
            "fax_number": "312-663-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 E. PARK STREET",
            "address_2": "1ST FLOOR, NORTH",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "62901",
            "telephone_number": "618-529-1151",
            "fax_number": "618-549-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY FOUNDATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GATEWAY FOUNDATION, INC",
        "enumeration_date": "2011-04-27",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "BRITTON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "312-663-1130",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": "A-0538-0043-A",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "A-0538-0043-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.