Gateway Nursing Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

GATEWAY NURSING SERVICES

Doing business as

Gateway Support Services

Practice address

4106 Brown Bark Cir
Randallstown, MD 21133-2054

Phone

(443) 743-0761

NPI assigned

Mar 15, 2019

Last updated

Mar 15, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Victor Jaiyeola

Title

Ceo

Phone

(443) 743-0761

Specialties & licenses 1

Addresses

Other names 1

• Gateway Support Services Doing business as

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552608000000",
    "number": "1447719828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 BROWN BARK CIR",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332054",
            "telephone_number": "443-743-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4106 BROWN BARK CIR",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211332054",
            "telephone_number": "443-743-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY NURSING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-15",
        "last_updated": "2019-03-15",
        "status": "A",
        "authorized_official_last_name": "JAIYEOLA",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-743-0761"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Support Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.