Provider Demographics
NPI:1306311626
Name:GATEWAY RECOVERY CENTER, LLC
Entity type:Organization
Organization Name:GATEWAY RECOVERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-856-7145
Mailing Address - Street 1:1303 N STATE ROAD 7 STE B1
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-2852
Mailing Address - Country:US
Mailing Address - Phone:561-856-7145
Mailing Address - Fax:
Practice Address - Street 1:1303 N STATE ROAD 7 STE B1
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-2852
Practice Address - Country:US
Practice Address - Phone:561-856-7145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-13
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder