NPIMap

Organization Active NPI

Gatehouse Therapeutic Health Services

  • Substance Abuse Rehabilitation Facility
  • Wickenburg, AZ
National Provider Identifier
1609184050
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
BH-2644 Issued in AZ
Legal business name
GATEHOUSE THERAPEUTIC HEALTH SERVICES
Practice address
159 W Wickenburg Way
Wickenburg, AZ 85390-2265
Phone
(928) 668-0710
Fax
(928) 684-6852
NPI assigned
Sep 20, 2010
Last updated
Sep 20, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
TRANSITIONAL LIVING CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Authorized official

Name
Dan D Sours, MC, LPC
Title
Clinical Director
Phone
(928) 668-0710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X BH-2644 AZ Primary

Addresses

Primary practice location

159 W Wickenburg Way
Wickenburg, AZ 85390-2265

Mailing address

159 W Wickenburg Way
Wickenburg, AZ 85390-2265
Phone (928) 668-0710

National Provider Directory

National Provider Directory
Tax ID family
Transitional Living Corporation4 organizations share this tax ID, including this one
Part of
Transitional Living Corporation

Other organizations with this tax ID 3

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

Locations

159 W Wickenburg Way
Wickenburg, AZ 85390
Phone (928) 668-0710

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1609184050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 W WICKENBURG WAY",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853902265",
            "telephone_number": "928-668-0710",
            "fax_number": "928-684-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 W WICKENBURG WAY",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853902265",
            "telephone_number": "928-668-0710",
            "fax_number": "928-684-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEHOUSE THERAPEUTIC HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRANSITIONAL LIVING CORPORATION",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "SOURS",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "928-668-0710",
        "authorized_official_credential": "MC, LPC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": "BH-2644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wickenburg, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.