NPIMap

Organization Active NPI

Gateway Foundation, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Jacksonville, IL
National Provider Identifier
1568970663
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
GATEWAY FOUNDATION, INC.
Practice address
1300 Lincoln Ave
Jacksonville, IL 62650-3112
Phone
(877) 505-4673
NPI assigned
Jan 11, 2018
Last updated
Dec 28, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GATEWAY FOUNDATION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Authorized official

Name
Renee Ennis McGee
Title
Program Support Manager
Phone
(678) 445-4833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

1300 Lincoln Ave
Jacksonville, IL 62650-3112

Mailing address

55 E Jackson Blvd Ste 1500
Chicago, IL 60604-4184
Phone (678) 445-4833

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

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1568970663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E JACKSON BLVD STE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606044184",
            "telephone_number": "678-445-4833",
            "fax_number": "312-663-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 LINCOLN AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503112",
            "telephone_number": "877-505-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY FOUNDATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GATEWAY FOUNDATION, INC.",
        "enumeration_date": "2018-01-11",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "ENNIS",
        "authorized_official_title_or_position": "PROGRAM SUPPORT MANAGER",
        "authorized_official_telephone_number": "678-445-4833"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.