NPIMap

Organization Active NPI

Gateway Behavioral Health Services

  • Developmentally Disabled Services Day Training Agency
  • Brunswick, GA
National Provider Identifier
1285767061
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
GATEWAY BEHAVIORAL HEALTH SERVICES
Practice address
2809 4TH Street
Brunswick, GA 31520
Phone
(912) 264-1674
Fax
(912) 262-9836
NPI assigned
Mar 13, 2007
Last updated
Oct 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 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
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

2809 4TH Street
Brunswick, GA 31520

Mailing address

700 Coastal Village Dr
Suite 102
Brunswick, GA 31520-1974
Phone (912) 554-8510

Other identifiers 1

IdentifierTypeStateIssuer
000625424AMedicaidGA

Other names 1

  • Gateway BHS - Glynn TC Now Other name

National Provider Directory

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

Organizations with this tax ID in the same state 24

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

View all 24

Locations

2809 4th St
Brunswick, GA 31520
Phone (912) 264-1674

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": "1318896000000",
    "number": "1285767061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 COASTAL VILLAGE DR",
            "address_2": "SUITE 102",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315201974",
            "telephone_number": "912-554-8510",
            "fax_number": "912-264-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 4TH STREET",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-264-1674",
            "fax_number": "912-262-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-10-18",
        "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": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000625424A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway BHS - Glynn TC Now",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 18, 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.