NPIMap

Organization Active NPI

Gateway Behavioral Health Services

  • Counselor
  • Thunderbolt, GA
National Provider Identifier
1891824025
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
GATEWAY BEHAVIORAL HEALTH SERVICES
Practice address
415 Bonaventure Rd
Thunderbolt, GA 31404-3299
Phone
(912) 790-6527
Fax
(912) 644-7729
NPI assigned
Mar 5, 2007
Last updated
Nov 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Authorized official

Name
Mrs. Rachel Skinner
Title
Director of Reimbursement
Phone
(912) 554-8498

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

415 Bonaventure Rd
Thunderbolt, GA 31404-3299

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
000859141BMedicaidGA
000859141AMedicaidGA

Other names 1

  • Gateway BHS - SCS Bonaventure C & A Outpatient Other name

National Provider Directory

National Provider Directory
Tax ID family
Marsh Haven72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

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

View all 23

Locations

415 Bonaventure Rd
Thunderbolt, GA 31404
Phone (912) 790-6526

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1891824025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 COASTAL VILLAGE DR",
            "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": "415 BONAVENTURE RD",
            "city": "THUNDERBOLT",
            "state": "GA",
            "postal_code": "314043299",
            "telephone_number": "912-790-6527",
            "fax_number": "912-644-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "912-554-8498",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000859141B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000859141A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway BHS - SCS Bonaventure C & A Outpatient",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Thunderbolt, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.