NPIMap

Organization Active NPI

Gateway Foundation, Inc

  • Substance Abuse Rehabilitation Facility
  • Carbondale, IL
National Provider Identifier
1699191700
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
C/A-0538-0050-A Issued in IL
Legal business name
GATEWAY FOUNDATION, INC
Practice address
1080 E Park St
West Wing
Carbondale, IL 62901-3812
Phone
(618) 529-1151
Fax
(618) 549-9540
NPI assigned
Mar 13, 2014
Last updated
Sep 24, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
GATEWAY FOUNDATION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X C/A-0538-0050-A IL Primary

Addresses

Primary practice location

1080 E Park St
West Wing
Carbondale, IL 62901-3812

Mailing address

55 E Jackson Blvd
Suite 1500
Chicago, IL 60604-4466
Phone (312) 663-1130

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": "1394668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537747200000",
    "number": "1699191700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E JACKSON BLVD",
            "address_2": "SUITE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606044466",
            "telephone_number": "312-663-1130",
            "fax_number": "312-663-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 E PARK ST",
            "address_2": "WEST WING",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013812",
            "telephone_number": "618-529-1151",
            "fax_number": "618-549-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY FOUNDATION, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GATEWAY FOUNDATION, INC.",
        "enumeration_date": "2014-03-13",
        "last_updated": "2018-09-24",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "ENNIS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-445-4833"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "C/A-0538-0050-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.