Gateway Residential Services

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

GATEWAY RESIDENTIAL SERVICES

Practice address

3338 Ash Mesa Rd
Delta, CO 81416-8766

Phone

(970) 823-0033

NPI assigned

Nov 14, 2021

Organization subpart

No

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

Authorized official

Name

Kevin Graves

Title

Management Agent

Phone

(970) 823-0033

Specialties & licenses 2

Addresses

Tax ID family

Gateway Residential Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Gateway Residential Services

  • Mental Illness Community Based Residential Treatment Facility
  • Delta, CO
  • NPI 1598044547
  NPD tax ID

Locations

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

{
    "created_epoch": "1636848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637712000000",
    "number": "1235895244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3346 ASH MESA RD",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814168766",
            "telephone_number": "970-823-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3338 ASH MESA RD",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814168766",
            "telephone_number": "970-823-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-14",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGEMENT AGENT",
        "authorized_official_telephone_number": "970-823-0033"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon April Fritchman, MA, NCC, LPC
• Dory B Funk III, MD
• Glenda G Gallego, RN
• Erin Michelle Gallob
• L Allison Michel Garnier, CAC III
• Gateway Residential Services
• Gateway Residential Services
• George T Evans DC PC
• Marcilynn Germann, HIS
• Elliot George Ghorayeb, MD

• Mental Illness Community Based Residential Treatment Facility in Delta, CO
• Providers in Delta, CO by specialty
• Mental Illness Community Based Residential Treatment Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.