NPIMap

Organization Active NPI

Gateway to Change

  • Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1952679458
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
396006491 Issued in WI
Legal business name
GATEWAY TO CHANGE
Practice address
2319 W Capitol Dr
Milwaukee, WI 53206-1919
Phone
(414) 442-2033
NPI assigned
Dec 12, 2011
Last updated
Dec 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Mr. Quin O Garrett, MS,CSW,CSAC,CCS
Title
Clinical Supervisor
Phone
(414) 442-2033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 396006491 WI Primary

Addresses

Primary practice location

2319 W Capitol Dr
Milwaukee, WI 53206-1919

Mailing address

2319 W Capitol Dr
Milwaukee, WI 53206-1919
Phone (414) 442-2033

National Provider Directory

National Provider Directory
Tax ID family
Gateway to Change3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1952679458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532061919",
            "telephone_number": "414-442-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532061919",
            "telephone_number": "414-442-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY TO CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "QUIN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "414-442-2033",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS,CSW,CSAC,CCS"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": "396006491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.