Gate Lodge of Florida, LLC

Primary specialty

Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X

License

3147221878801 Issued in FL

Legal business name

GATE LODGE OF FLORIDA, LLC

Practice address

3395 11TH CT
Vero Beach, FL 32960-5054

Phone

(772) 617-1717

Fax

(772) 778-9032

NPI assigned

Jul 25, 2017

Organization subpart

Yes

Parent organization

ORIGINS BEHAVIORAL HEALTHCARE, LLCAs reported in NPPES

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

Authorized official

Name

Robert B Rowling Jr.

Title

Ceo

Phone

(214) 283-8500

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1952824567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 45TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-841-1142",
            "fax_number": "561-841-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3395 11TH CT",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605054",
            "telephone_number": "772-617-1717",
            "fax_number": "772-778-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATE LODGE OF FLORIDA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORIGINS BEHAVIORAL HEALTHCARE, LLC",
        "enumeration_date": "2017-07-25",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "ROWLING",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-283-8500",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": "3147221878801",
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "FL",
            "license": "3147221878801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deedra R Garrison, PA-C
• Cindi Marie Gaskin, RMHCI
• Carina Danielle Gasparini
• Olivia Gasparro
• Sidney Ailene Gaston, DPT
• Jennifer Justice Pritikin Gattuso, MASW, LCSW
• Natalie Gaudet
• Leslie Evers Gaughran, MS CCC SLP
• Peggy Ann Gavigan, RD
• Jay Gawler

• Substance Use Disorder Rehabilitation Hospital Unit in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Substance Use Disorder Rehabilitation Hospital Unit in Florida

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