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Gateway Behavioral Health Services

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Savannah, GA

NPI 1992838692 · NPPES record last updated Mar 4, 2009

Key facts

NPI
1992838692
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
GATEWAY BEHAVIORAL HEALTH SERVICES
Practice address
8510 Waters Avenue
Savannah, GA 31406
Phone
(912) 921-5582
Fax
(912) 920-6628
NPI assigned
Mar 13, 2007
Organization subpart
No

Authorized official

Name
Mr. William Parks, CPA CFO
Title
Chief Financial Officer
Phone
(912) 554-8464

Corporate family (same tax ID) 13

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

National Provider Directory

Tax ID family
Gateway Community Service Board (72 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

8510 Waters Avenue
Savannah, GA 31406

Mailing address

3441 Cypress Mill Road
Suite 2
Brunswick, GA 31520
Phone (912) 264-0979

Other identifiers

IdentifierTypeStateIssuer
000625303AMedicaidGA

Other names

  • Gateway Behavioral Health Services Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 4, 2009.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1992838692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 CYPRESS MILL ROAD",
            "address_2": "SUITE 2",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-264-0979",
            "fax_number": "912-264-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8510 WATERS AVENUE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31406",
            "telephone_number": "912-921-5582",
            "fax_number": "912-920-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "912-554-8464",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA CFO"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000625303A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Behavioral Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Savannah, GA

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Sources for this page

Verify at the official NPI Registry.