NPIMap

Organization Active NPI

Gateway Behavioral Health Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Thunderbolt, GA
National Provider Identifier
1891828653
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
025010119 Issued in GA
Legal business name
GATEWAY BEHAVIORAL HEALTH SERVICES
Practice address
415 Bonaventure Rd
Thunderbolt, GA 31404-3299
Phone
(912) 790-6526
Fax
(912) 790-3460
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 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
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 025010119 GA 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 1

IdentifierTypeStateIssuer
000622553AXMedicaidGA

Other names 1

  • Gateway BHS - Chatham TC Comp Other name

National Provider Directory

National Provider Directory
Tax ID family
Gateway Community Service Board72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319414400000",
    "number": "1891828653",
    "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": "912-790-6526",
            "fax_number": "912-790-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-10-24",
        "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": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "025010119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000622553AX",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway BHS - Chatham TC Comp",
            "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 Oct 24, 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.